Name (*)

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Address (*)

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City (*)

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State (*)

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Zip (*)

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Email (*)

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Occupation Host Father

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Occupation Host Mother

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How many players you are interested in housing (*)
12345678910
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How many miles from your house to the Covelli Centre (*)

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How many miles from your house to the Ice Zone (*)

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Do you have any children? (Names, ages, gender) (*)

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Do you have any pets? (Please list types, how many, and if they are inside/outside) (*)

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Have you ever hosted an exchange student or player before? (*)

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What are your household work schedules? Does it involve travel? (*)

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Please list any household rules/chores which you want your player to adhere to. (*)

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Describe the accommodations that will be available for the player (bed size, tv?, private bathroom/entrance, etc…) (*)

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Hockey players tend to eat a lot. Are you willing to provide the necessary meals for them to be full and productive on and off the ice? (*)
YesNo
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USA Hockey guidelines stipulate that background checks are to be conducted. Would you object to have a background check on you and your family? (*)
YesNo
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Please tell us why you are interested in becoming part of the Phantoms Host Family program. (*)

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Please list any questions/concerns/additional info you would like

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