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Player Information

Are you a returning Player?

First Name *


Last Name *


Birthdate *


Hockey USA Number *

Email Address *


Verify Email Address *


Health Card Number


Address *


City / Hometown *


State *



Zip Code *


Phone Number *


Secondary Phone Number


Please indicate Age Group *

Parent/Guardian Information

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Email Address *

Parent/Guardian Phone Number *

Parent/Guardian Secondary Phone Number

 
Parent/Guardian Address *

Parent/Guardian City *

Parent/Guardian Province / State *


Parent/Guardian Postal / Zip Code *

Parent/Guardian 2 Information

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Parent/Guardian 2 Email Address

Verify Parent/Guardian 2 Email Address

Parent/Guardian 2 Phone Number

 
Parent/Guardian 2 Address

Parent/Guardian 2 City

Parent/Guardian 2 Province / State


Parent/Guardian 2 Postal / Zip Code

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