Your Name (required)

    Your Email (required)

    Phone Number (required)

    Shoot L Or R (required)

    Height (required)

    Weight (required)

    Date Of Birth (required)

    Position (required)

    Home Address

    Medical Conditions Or Injuries (required)

    Last Team Registered (required)

    Last League Registered (required)

    GM Name

    GM Email

    GM Phone

    Last Grade Completed (required)

    SAT Or ACT Score

    Fathers Name (required)

    Mothers Name (required)

    Mothers Email

    Father's Email

    Mother's phone number (required)

    Father's phone number (required)

    How Did You Hear About The Express (required)

    What Do You Want To Achieve By Playing Junior Hockey (required)

    Why Should We Take You Over Other Players

    Message to Coachs and Scouts

    Would you like to attend our spring camp in North Bay Sat April 13th? (required)

    Would you be interested in playing in a Spring/Summer tournament for the Express this off season? (required)