Nepean Raiders - Propsects Submission Form

Interested in playing for the Nepean Raiders? Complete the entry form below and you may just have the opportunity. A team official will be in contact with you soon concerning your interest in playing for Nepean.

Name:  
Address:  
City:  
Prov / State:  
Postal Code / ZipCode:  
Home Phone:  
Work Phone:  
Email Address:  
Parent's Names:  
Position:  
Shot/Catch:  
Date of Birth:  
 Select Date
Height:  
Weight:  
Last Year's Team:  
Last Year's Level Played:  
Last Year's Coach:  
Coach's Phone:  
Coach's Email:  
Years of Hockey Experience:  
Comments: