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Canterbury Performance Centre Player Registration Nov-Dec 2023
Please complete this registration form if you wish to register for Block One of the November 2023 Canterbury Performance Centre programme.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Date of Birth
*
Your answer
Email Address
*
Your answer
Mobile Number
*
Your answer
Emergency Contact Name & Number
*
Your answer
2023 Club Team
*
Your answer
2023 Grade
*
CPL
Division One
Did not play for a club
Required
2023 School Team (SSP)
*
Your answer
2023 Representative Team
*
Cats
Cavaliers
Barracudas
Beavers
Canterbury U23
Canterbury U18A
Canterbury U18B
Canterbury U18 Development
Another Association
Did not play representative hockey in 2023
Required
If you played for a representative team other than Canterbury please name
Your answer
Please indicate if you are in or attended the following:
*
Contracted Blacksticks
Junior Blacksticks 2023 World Cup team
Attended the 2023 U21 Super Camp
Attended the 2023 U18 Super Camp
None of the above
Required
Please indicate what days you will be attending sessions.
*
Mondays only
Wednesdays only
Mondays and Wednesdays
Required
Email Address for invoicingÂ
*
Your answer
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