The Buccaneers are back in action this Thursday night taking on the Victoria Cougars at 715 pm Nanaimo Ice Centre. Come out and cheer on your local talent.

Host Family Application

Applicant Name:
Applicant Age:

Spouse Name:
Spouse Age:

Address:
City:
Postal Code:

Email Address:
Home Phone:
Cell Phone:
Work Phone:

Do you have children at home?
If yes:
Child 1 Age: M or F:
Child 2 Age: M or F:
Child 3 Age: M or F:

Do you or your spouse work from home?
Applicant Occupation: Applicant Employer:
Spouse Occupation: Spouse Employer:

Do you have pets?
If yes please list:
Pet 1
Pet 2
Pet 3

Do you have internet access?

Have you ever hosted before?

Is your home smoke free?

How many players are you interested in hosting?

Are you interested in helping if a short term host situation is required?

Tell us why you would like to Host a Buccaneer:

Featured Sponsors

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