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Main Camp Bethlehem, PA 2012
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Camp Registration Form

Please fill in your information below.
Fields marked with an asterisk (*) are required.

Contact Information
* Parent(s) Name 
* Parent(s) Email 
 * Camper Name 
 Camper Email 
* Date of Birth
* Address 
* City
* State USA
* Zip Code
* Phone
* Cell Phone

Camp Information

Which camp do you want to attend?

Pennsylvania

Main Camp Bethlehem PA 2012 (more info)

Midget Development Camp Bethlehem PA 2012 (more info)

Mini Camp Bethlehem PA 2012 (more info)

What areas do you feel your child needs to work on?

       Attitude Stick Handling Skating
  Work Ethic Shooting Backwards Skating

What positions will your child play at the camp?

Center Left Wing Right Wing  Defence  Goal

What is your child's jersey size?

Youth Large Adult Small Adult Medium Adult Large Adult X-Large

What is your prior team?

Name 
Location
Level

Please reserve a spot for Camp Corupe 2012 as indicated above. I am enclosing a $50 deposit payable to Camp Corupe, LLC. Mail to P.O. Box 1754 Bethlehem, PA 18016

I understand that the remaining balance is due before the first day of camp.

A confirmation letter and other forms will be sent to you upon receipt of your payment. Camp Corupe reserves the right to change or cancel program content at its sole discretion. Camp Corupe also reserves the right to place campers into groups at its sole discression, regardless of the campers age.


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