Tryout Camp Registration Form

Madison Capitols - Winter 2008/2009 Season

June 20th – 22nd

Please Print

Name

Birth date

Address

City                                                                 State                     Zip

Phone                                                              E-mail

Position                                                           Shoots      Left   /   Right

Height                                                             Weight

2007/08 Team

Parent/Guardian

Phone (if different from above)

Mail the registration form and $75 tryout fee payable to Madison Capitols, to the address below - or fax your registration with credit card info to 608-821-1221.

Madison Capitols Hockey

Attn: 2008 Tryout Camp

2616 Pleasant View Road

Middleton, WI  53562

 Method of payment:      Check         Cash          Credit Card

Credit Card Type                                    Exp. Date

Credit Card No.

Signature

(required if paying by credit card)