Medicine Hat Cubs Junior Hockey Club Billet Questionnaire

Please copy the information below and paste it into a word processor. Once complete, save and email to medhatcubs@gmail.com.  All information will be held in confidence.
 
 
Name of adults in household:
______________________________________________________________________________

Are any of the adults in your household between the ages of 16 and 25?
______________________________________________________________________________

How many children aged 15 and under live in your household?
______________________________________________________________________________

Have you acted as a billet in the past?  If yes, for how long?  Which team?
______________________________________________________________________________
______________________________________________________________________________

If you answered YES to the previous question, what are some positive thoughts and/or experiences you could share regarding being a billet parent?
______________________________________________________________________________
______________________________________________________________________________
 
If you are interested in becoming a billet for the first time, could you give some thoughts and/or ideas on what you are hoping the experience would be like for you and your family?
______________________________________________________________________________
______________________________________________________________________________
 
If you are a current billet, would you continue if the same player(s) were to return to your home this season? 
YES / NO / Not applicable
 
If you are a current billet, would you prefer a new and/or different player(s) in your home this season? 
YES / NO / Not applicable
 
Respecting the need for privacy, can you provide a player or players with a separate bedroom? 
YES / NO
 
Do you believe the player should integrate and become a part of your family, accepting house rules and participating when possible in family activities? 
YES / NO
 
Are you available to provide meals (breakfast, packed lunches, dinner) for the player?
YES / NO
 
If you are not available, would you be willing to help teach the player how to cook some simple nutritious meals?
YES / NO
 
Are you comfortable with ensuring players are following team guidelines and curfew limits?
YES / NO
 
Do you have any pets in your household?
YES / NO
 
If yes, please identify what kind of pets:
______________________________________________________________________________
 
Do you have any residents in your household that smoke?
YES / NO
 
Do the smokers smoke inside the home?
YES / NO
Would a player’s religious denomination play a role in determining if he was going to be welcome in your home?
YES / NO
 
Do you have a preference of religious denomination which may fit within your family home and lifestyle?
YES / NO
 
Do you have a preference of age for the player or players you would like to have in your home?
YES / NO
 
Do you have room for more than one player in your home?
YES / NO
 
If you are unable to commit for an entire season as a full time billet, would you be willing to act as a temporary billet during Spring Camp/Main Camp?
YES / NO
 
Would you be willing to act as a temporary billet during the season for affiliate players or in the event a full time billet is temporarily away?
YES / NO
 
Do you have additional thoughts or comments that you would like to share with our organization that would assist the players and billeting families?
______________________________________________________________________________

The Medicine Hat Cubs Junior Hockey Club value billeting families and the important contribution they provide the team.
 
 
CONTACT INFORMATION:
 
Family Name:__________________________________________________________________
 
 
Address:_______________________________________________________________________
 
 
Home Phone:__________________________________________________________________
 
 
Cell Phone(s):__________________________________________________________________
 
 
Email:_________________________________________________________________________