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Shawnee Ice Hockey Registration Form

This registration form collects contact and player information for the Shawnee Ice Hockey Club's 2011-2012 season. It requests the player's name, date of birth, address, phone numbers, email addresses, preferred position, previous jersey number, and hockey experience level. The bottom section is for a parent or guardian's name and signature consenting to the player's participation.

Uploaded by

Nancy Barton Misiewicz
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© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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6 views1 page

Shawnee Ice Hockey Registration Form

This registration form collects contact and player information for the Shawnee Ice Hockey Club's 2011-2012 season. It requests the player's name, date of birth, address, phone numbers, email addresses, preferred position, previous jersey number, and hockey experience level. The bottom section is for a parent or guardian's name and signature consenting to the player's participation.

Uploaded by

Nancy Barton Misiewicz
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

_____New to Club?

USA HOCKEY (valid thru 2012) # __________________

Shawnee Ice Hockey Club Fall 2011/2012 Registration Form


I give consent for ________________________a pupil at ______________ High School/Middle School to play
Ice Hockey for Shawnee Ice Hockey Club during the 2011/2012 season.
NAME____________________________________

DATE OF BIRTH__________________________

ADDRESS_________________________________

GRADE (next school year: Sept 2011) _________

__________________________________________

PARENTS NAMES________________________

HOME PHONE#: ________________________

CELL PHONE#: _____________________(Mom)

CELL PHONE#: ____________________(Dad)

CELL PHONE#: ____________________(Player)

E-Mail (Parent):_____________________________
E-Mail (Parent):_____________________________

E-Mail (Player): ____________________________


(indicate which one(s) for emails from club with *)

_______________________________________________________________
________________________________

Parent or Guardian Name (Print)

Date

______________________________________________

______________________________________________

Parent or Guardian Signature

Players Signature

PREFERRED POSITION: F__ D__ G__

SHAWNEE NUMBER LAST SEASON: _______

If non-Shawnee Jersey at try-outs: Color/Description & Number ________________


RETURNING PLAYERS WEAR YOUR SHAWNEE JERSEY WITH YOUR NAME AND NUMBER

HOCKEY EXPERIENCE PROFILE:


2011/2012 Season
2010/2011 Season
2009/2010 Season
No Travel Experience____
Midget Major
Midget Major
Midget Major
Midget Minor
Midget Minor
Midget Minor
In-House Experience_____
Bantam
Bantam
Bantam
Pee Wee
Pee Wee
Pee Wee
Squirt
Squirt
Squirt
Mite
Mite
Mite
-----------------------------------------------------------------------------------------------------------------------------------LEVEL:
AAA
AAA
AAA
AA
AA
AA
A
A
A
B
B
B
In-House
In-House
In-House
-----------------------------------------------------------------------------------------------------------------------------------Organization:
_____________
_____________
_______________
_____________
_____________
_______________
CLASS:

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