Youth Hockey Registration Form

Parent/Guardian Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Player Name*

First NameLast Name

Date Of Birth

Date

Age*

Experience Level:*

Division*

Youth Camp (March)- March 1 - March. 30th. (Date and Time TBD)Youth Hockey - Learn To SkateYouth Hockey - Learn To Play10u Youth League (Co-Ed)12u Youth League (Co-Ed)14u Youth Hockey League (Co-Ed)CCSA Rage Club Hockey TeamOther (Please Describe)

Shirt Size*

Where did you hear about us? *

Would you or someone you know be interested in joining our Volunteer group?*

Additional Questions or Comments/ Food allergies?*

Please let us know if you have any other Questions or Comments!

What would you like to see from the program(s) this season?*

Please verify that you are human*

Signature

Youth Hockey Registration Form

Parents/Guardian Information

Player Information (1 Player Per Registration)