Registration Fill out this form and send payment by June 1st, 2015. Please send form & payments to: Mike Levis 329 Mayfair Street, Antigo, WI 54409 Practice with the Pros! JOE PISKULA summer hockey camp Player’s Name:__________________________ Address:_______________________________ City, State, Zip:_________________________ Phone:_________________________________ Work Phone:____________________________ Email:_________________________________ Insurance Company:______________________ Policy Number:__________________________ Youth or Adult Jersey (circle one) Small Medium Large XLarge (circle one) Hockey Camp Session: Circle group that player will be next season Girls Bantam Mites Squirts High School Pee Wee High School 4x4 & Scrimmages only The undersigned agrees that the Antigo Summer Hockey Programs and Antigo Area Youth Hockey Association (AAYHA) are not held responsible for accidents, injury, or loss of property, however caused, and agrees to release AAYHA and the coaches for all claims that may arise as a result of such accidents or losses. Participants are required to supply all recommended equipment and provide proof of USA Hockey membership. I have read the forgoing and agree on the terms and conditions. ________________________________ Signature of Parent / Legal Guardian ________________ Date -and- High School 4x4 & Scrimmages information: www.antigohockey.com final schedule posted one week before camp ECONOMICAL Over 25 hours of ice for $200 or less Includes team building exercises and ropes course! June 14th-19th Antigo, Wisconsin HOCKEY SCHOOL FEES* SUNDAY, JUNE 14th Goalies...................................................$60 Player Check-In and Girls.......................................................$200 Family Cookout! Mites......................................................$70 starting at 5 p.m. Squirt, Pee Wee, Bantam.......................$200 Second Family Member (if younger)....$140 Please join us for a fun-filled evening welcoming parents and players to summer hockey camp! High School (grades 9-12)....................$200 scrimmages included High School (scrimmages only)............$70 *Please make checks payable to AAYHA $50 deposit to hold spot Balance due on June 1st Please Note! equipment: Each player will receive an official camp jersey. Players must wear ALL equipment required by USA Hockey. Shorts and tennis shoes required for dryland. No jeans or sandals! on ice sessions include: Daily power skating and/or overspeed interval skating, skill development, team concepts, and small area games. dryland sessions include: Shooting, puck handling, strength, agility, quickness training, street hockey games, instructional video, goal setting, and some lecture. high school 4 x 4 & scrimmages: Nightly games against regional teams or 4 on 4 scrimmages concessions: Open at all times providing a “featured meal of the day” Coaching Profiles JOE PISKULA Captain of the Milwaukee Admirals 8 years of professional experience (NHL & AHL) NCAA Division 1 - Wisconsin Badger Alumni 2002 Antigo High School Graduate JOSH ENGEL Head Coach Arrowhead High School 4 years of professional experience (AHL) NCAA Division 1 - Wisconsin Badger Alumni 2003 Rice Lake High School Graduate ANDY BRANDT Head Coach Gwinnett Gladiators (ECHL) 6 years of professional experience (AHL & ECHL) NCAA Division 1 - Wisconsin Badger Alumni 2001 Wausau West High School Graduate - Receive jersey - Food and drinks - Open hockey -Live music! Tentative Schedule: Squirts 8:30am - 1:30pm PW/Bantams 10am - 3:15pm High School 2:15 - 5:45pm Mites 6 - 7pm Coaching Profiles Mike Hanke Assistant Coach D.C. Everest High School NCAA Division III - Saint John’s Alumni 2001 Antigo High School Graduate Questions? Dom Hilger: 414.708.9711 - [email protected] Mike Levis: 715.623.3890 - [email protected]