^{Last Name:     First Name:    MI:}  

^{Address:      
 
City:               State/Prov:       Zip:}   

^{Date of Birth:}    (enter with slashes   mm/dd/yyyy)

^{Home Phone:           Parent Cell#:}             

^{Parent/Guardian    First Name:    Last Name:}   

^{E-Mail Address:      
 
E-Mail Address:}      

______________________________________________________________________

^{Primary Position: Forward      Defense   Goaltender                         Shot / Catch:   Right      Left}

^{School Grade:     School GPA:     ACT:     SAT:}  

^{Current Team:         Current Coach:}         

^{Coaches Phone:     Coaches E-Mail Address:}     

______________________________________________________________________

^{Bauer Training Academy}

^{Residential Camp:  YES    NO
July 17-21, 2011 - $700}  

^{College Coaches Weekend:  YES    NO     
July 16-17, 2011 - $150}

^{BOTH:  YES    NO     
 $799}