Hookin2Hockey - Program Registration

Please be aware that the information you provide in your registration will the content for your promotional flyers
Program/Centre Name *
State/Territory *
Affiliated Club/Association (type N/A if privately run) *
Coordinator Name *

First Name Last Name
Coordinators Phone Number *

- Area Code Phone Number
Coordinator Email Address *
Program name if different to club/centre

Program Location *

Postal Address (NOT A PO BOX)

Club/Program Website
Program Start Date/Time *

- Day - Month Year
at
: Hour Minutes
How many free promotional flyers would you like for your program?
Any additional information you would like added to your promotional flyers:

0/243
Please add any comments or questions you may have regarding your up and coming Hookin2Hockey program?
Terms and Conditions *

By registering your centre online, you are agreeing to the following Terms and Conditions. http://hookin2hockey.com.au/terms-and-conditions/
Should be Empty: