First Name:*
Last Name:*
M.I.:
Date of Birth:*
Jersey Size:* ---Youth - SmallYouth - MediumYouth - LargeYouth - X-LargeAdult - MediumAdult - LargeAdult - X-LargeAdult - XX-Large
Sex:* ---MaleFemale
Home Address:*
City:* State:* Zip Code:*
Email:*
Father's Name: Phone #: Email:
Mother's Name: Phone #: Email:
Guardian's Name: Phone #: Email:
Two Emergency Contact Names, Relationship to Child and Phone Numbers:
Medical Insurance Company:
Physician Name/Number:
Please read the forms below before submitting your registration:
General Information - Parents/Legal Guardian - *Please enter your initials:
Please read the liability forms below to determine which form is applicable to you. Please answer both questions.
Limitation of Liability for Minor Participants - *Please enter your initials or enter NA if this form is not applicable to you:
Limitation of Liability for Participants - *Please enter your initials or enter NA if this form is not applicable to you:
Medical Release Form
Please acknowledge you have read this form*: ---Yes
Fundraiser Commitment Letter
Will you participate in the Fundraiser?* ---I Will ParticipateI Will Not Participate
Do you have interest in being a Coach?---YesNo
Do you have interest in being a Referee ?---YesNo
Do you have interest in being a Team Parent ?---YesNo
*All registration fees must be paid in full after submission. You'll be redirected to Paypal after submitting your registration.