Clinic Request for a New Location
Contact Information

Our form requires a name to be associated with a request. if you'd like to be contacted if we have questions about your request, please provide an email address.

First Name
Last Name
Email
Additional Information
information about other rinks, nearby cities, rink/association contacts, hockey population, etc.
Rink Information

Please provide information about a local rink that we should consider using the the area.

Rink Name
Physical Address Street
If you know it, please provide. If not, we'll find it.
City
State or Province
Hockey Population
Please enter an approximate Hockey population for the area.
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