Youth Hockey Program – Billet Host Application Form

    Host Family Information:

    Contact Information:

    Home Phone:
    Mobile Phone:
    Email Address:



    House Hold Information:

    Street Address:
    City:
    Province/State:
    Postal/Zip Code:
    How Many Years At Current Address?



    Number of people living in your household:
    Adults:
    Children:


    Do you have any pets?
    If yes what type of pet?


    Do you smoke or allow smoking in your home?
    Do you have a private room available for a player?



    Billet Experience and Availability

    Have you ever hosted a youth hockey player before?
    If yes, for how long?
    Why are you interested in hosting a hockey player?
    Do you have any specific preferences for the type of player you would like to host? (age, position, etc.)




    Transportation and Accessibility

    Do you have reliable transportation to and from the rink?
    How far is your home located from the rink? (Please provide approximate distance)
    Are you able to assist with transportation to team practices, games, or events if needed?


    Emergency Contact Information

    Emergency Contact Name:
    Emergency Contact Home Phone:
    Emergency Contact Mobile Phone:
    Emergency Contact Relationship to the Host Family:




    Background and Screening

    To ensure the safety of all participants, the youth hockey program will require background checks and references for all potential billet hosts
    Please list two personal or professional references (name, relationship, and contact information):

    Reference #1:

    Name:
    Relationship:
    Phone Number:
    Email Address:

    Reference #2:

    Name:
    Relationship:
    Phone Number:
    Email Address:




    Additional Information

    Please feel free to provide any additional information about yourself, your family, or your home that you think would be helpful for us to know as we evaluate your application.



    Signature and Agreement

    By checking the box below, I/We confirm that the information provided in this application is accurate and complete to the best of my knowledge. I/We understand that being selected as a billet family may involve a background check, and I/We agree to follow the rules and guidelines set forth by the youth hockey program.

    Today's Date


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