Free Hockey Camp Registration Form

Heartland Hockey Camp

Step 1: Fill Out The Following Info. NOTE: To be a valid submission all information must be completed.

Email:
Name:
Address:
City:	State: Zip:
Phone (Day)
Age:
Hockey Position:

Step 2: We would like to gather information on how you came to our site. Please complete the following.

How did you hear about our site.

	Search Engine
	Altavista
	Hot Bot
	Yahoo
	MSN
	AOL
	Excite

	Other
	Hockey Giant
	American Hockey
	Hockey News
	Word of Mouth
	Other Advertisement
	Previously Attended Camp

Would you like us to mail you our 2010 Brochure:
Yes
No

That is it. To submit your registration click on the "SEND TO HEARTLAND" box below. If you have made a mistake you may reset the form by clicking on the "START OVER" button.

Heartland Hockey Camps
24921 Arena Dr.
Deerwood, MN 56444
(218) 534-3298 Out of State Residents (800) 945-7465
Fax (218) 534-3297
E-Mail: Steve@heartlandhockey.com