Camper Name *

First Name

Last Name

Camper DOB *

MM

DD

YYYY

Shipping Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent / Guardian Name *

First Name

Last Name

Parent / Guardian Phone *

(###)

###

####

Will the Camper require Financial Assistance to attend camp? *

If yes, please fill out the questions below

Yes

No

In which area(s) will you need assistance?

Airfare

Hotel / Accomodations

Gas / Mileage

Other

I would like to receive information regarding hotels in the area *

Yes

No

I would like to receive information regarding other activities in the area *

Yes

No

NEW! Billeting program for US Campers to stay with Canadian Campers. *

Would you be open to hosting a Camper for 3 days? This will provide a unique and memorable experience for the girls! We will contact you with more information.

Yes, please contact me

No, I would not like to host a camper

I agree that by registering for this camp, the Camper is committed to attending all 3 days (July 11, 12, 13). If the Camper is no longer available to participate, I will promptly notify BGHC (blackgirlhockeyclubca@gmail.com) by June 27, 2025 to allow another participant to join the camp. *

Yes

No