Player Questionnaire

First name: *

Last name: *

Date of Birth: *

Street Address:

Town:

Postal Code or Zipcode:

Father Name:

Mother Name:

Home Phone:

Cell Phone:

Email Address:

Last Team Played:

League:

Stats

GP:

G/W:

A/L:

Pts./T:

PIM/G.A.A.:

SV%:

Coache's Name:

Coache's Phone:

Height:

Weight:

Hand Shoot:

1st Position:

2nd Position:

Last School Grade Completed:

Name of School:

Grade Point Average:

School Contact:

School Contact Phone Number:

Future School Ambitions:

Future Hockey Ambitions:

Favorite Team:

Favorite Player:

In one sentence describe the way you play the game:

Why do you want to play Junior A Hockey:

Most memorable hockey moment:

Do you want to receive more information from the Lakers organization:

Yes