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Registration
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Indicates required field
Student Name
*
First
Last
Phone Number # 1
*
Phone Number # 2
*
Age
*
Parents Names
*
Last Team
*
Jersey Size
*
XL
L
M
S
YXL
YL
Select Camp
*
Atlantic City Camp
Atlantic City Lessons
Atlantic City Camp & Lessons
Tom's River, NJ. Camps
Tom's River, NJ. Lessons
Tom's River, NJ Camps & Lessons
Power Play. PA Camps
Power Play. PA Lessons
Power Play. PA Camps & Lessons
Haverford, Pa Camps
Haverford, Pa Lessons
Haverford, Pa Camps & Lessons
Wake Forest, NC , Camps
Wake Forest, NC , Lessons
Wake Forest, NC , Camps & Lessons
Position
*
Goalie
Defense
Forward
Medical Allergies
*
Email
*
WAIVER
- I have full knowledge and understanding of the hazards and dangers of Ice Hockey, the serious injury that can happen, and certify that my son/daughter has medical coverage for any "bodily injury" that may occur
Guardian Name *By typing name you agree you have read the above Waiver*
*
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