Hockey Manitoba - Floorball Program Request

Floorball Program Request

We will do our best to accommodate all requests. Our ability to accommodate your requested date may be limited by staff availability and scheduling.

Please note that Hockey Manitoba's Floorball Program is a centralized program, operating out of Winnipeg, Manitoba. Rural requests are encouraged, but please be aware that we may be unable to accommodate all requests.

Respondent

You will receive a confirmation by email.

First name *

Last name *

Email *

Mobile

School / Organization Name *

* IF Applicant is a School* - School Division

Address *

Grades / Age Groups *

Number of Classes / Groups *

Day of Contact

First name *

Last name *

Email *

Mobile *

Dates & Times *

Please provide multiple options for dates. Floorball equipment can be kept for a maximum of 1 week.

Is There Parking Available? If So, Please Indicate Where Our Staff Can Park

* IF Applicant is NOT a School* - Does Your Organization Have a Liability Waiver / Release Form in Place for Participants?

Yes No x Clear

A required field has not been filled.

Please accept all conditions.

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