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  • Shawnee Ice Hockey Club Fall 2011/2012 Registration Form

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    Nancy Barton Misiewicz
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    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.

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    Original Title

    Shawnee Reg 2011

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    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.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    83 views1 page

    Shawnee Ice Hockey Club Fall 2011/2012 Registration Form

    Uploaded by

    Nancy Barton Misiewicz
    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.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as doc, pdf, or txt
    of 1

    _____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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