Roster Application - Head Coach (Burlington City Rep Hockey Club)

Print Roster Application - Head Coach
Please submit this form in order to be added to a team roster. You will be notified by email once this application has been accepted or rejected (email notification will include reason for rejection). If rejected it will be deleted from the database and you must resubmit this form once the requirements have been met.
  1. Person being added to the Team Roster
  2. Person being added to the Team Roster
  3. RadDatePicker
    Open the calendar popup.
    Required to access Hockey Canada profile
  4. Full Address including Postal Code
Contact Info
This contact info will be used by the Eagles Office Staff and Administration.
  1. Example: ###-###-####
  2. If NO, please complete Eagles Website Contact information below
  3. Not required if same as above
  4. Not required if same as above
Criminal Offence Declaration

  1. I hereby declare the above statements to be true
Human Validation