Red Berenson's Michigan Hockey Camp
2010 Summer Camp Individual Registration Form

If you are interested in attending Red Berenson's Michigan Hockey Camp, please fill out this online form and click the "submit" button to send it to the Red Berenson's Michigan Hockey Summer camp staff.
Date: (Month/Day/Year)

Camper Information:

Last Name:
 First name:
 M.I.:
Gender:
 Going into Grade:
Date of Birth:
 Age:
Street Address:
City:
 State or Province:
 Zip:
Home Phone:
Mother Name:
 Day Phone:
 E-mail:
Father Name:
 Day Phone:
 E-mail:

Player Information:

Position you would like to play: Years Experience:
Current Team: Level: (AAA, AA, House)

Red Berenson's 2010 Michigan Hockey Camp will be held the following dates:

Week 1 (July 4 - 8)
Week 2 (July 11 - 15)
Week 3 (July 18 - 22)
Week 4 (July 25 - 29)
Week 5 (August 1 - 5)

The cost for attending camp this year:

Resident - $525
Commuter - $370

I wish to enroll in the following sessions:

If you would like to attend one week, please fill out a first and second choice. If you would like to attend multiple weeks, please fill out the according choice spaces. (**Please note: Campers staying consecutive weeks must check out on Thursday evening and check back in on Sunday afternoon.)

# of weeks I would like to attend:

1st choice:
Week #:
Camper type:(Resident or Commuter)

2nd choice:
Week #:
Camper type:(Resident or Commuter)

3rd choice:
Week #:
Camper type:(Resident or Commuter)

4th choice:
Week #:
Camper type:(Resident or Commuter)

5th choice:
Week #:
Camper type:(Resident or Commuter)

Even though you are completing this online registration form, you are not guaranteed a spot in your desired week until we receive your non-refundable deposit. You will also be asked to fill out additional documentation and return anytime prior to your desired week of camp (available after you click the submit button).



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General Information (734) 647-1201