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Program Information

Location: Mt Vernon Rec Center - 12000 Government Center Parkway - Alexandria, VA 22035

Dates: Monday June 22 2026 - Thursday June 25 2026

Details: 4:00pm - 6:00pm

Group: Clinic: Group A: Ages 7 - 11

Cost: $400.00 USD

Admin Fee: $12.00 USD

Total: $412.00 USD

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Student Information

First Name

Last Name

Date of Birth

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Secondary Email Address

Hockey Experience

Current Organization

Billing Information

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Last Name

Address Line 1

Country

State

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Postal Code

Main Contact Information

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First Name

Last Name

Email Address

Phone Number

Phone Number Type

Emergency Contact Information

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First Name

Last Name

Email Address

Phone Number

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