Registration Form - All American Inline Hockey

REGISTRATION FORM – YOUTH ROLLER HOCKEY – ALL AMERICAN – FALL- 2022
Please complete the form below. We are committed to helping you and your player have an enriching experience while playing here. As a reminder we do not issue refunds, a credit will be given to you in the event of an injury during the session being played. Please feel free to contact us with any questions, comments or suggestions We welcome your feedback!

New Team Placement

PRIOR TEAM NAME

Child's Name

Experience Experience Roller Ice

Date of Birth

Home Phone

Cell Phone

*Maye we text you game/league information?

Player TShirt Size

Email Address

Mother's Name

Father's Name

Mailing Address

Are you a goalie?

Interested in coaching?

Name of School Currently Attending

Division Division 8U/Open Division (2011 & Younger) 10U 12U

12 + 9 =

Fees ($110.00) *Modified scheduled league for fall

FULL TIME GOALIES $25.00_____ 2nd Team Free_____(Goalies only)