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Puck cancer boy's & girl's registration
Please be prepared to pay once form is submitted.
*
Indicates required field
Participant Name
*
First
Last
Position
*
Skater
Goalie
Both
Player Age
*
Requested Dvision
*
Ages 12-14 Boys & Girls
2016 Name Of Team Played On
*
2016-2017 Team Type
*
House
Travel
Both
Unknown
Jersey Size
*
Youth Small
Youth Medium
Youth Large
Youth Goalie
Adult Small
Adult Medium
Adult Large
Adult XLarge
Adult 2X
Adult Goalie
Parent Name
*
Email
*
Phone (ICE)
*
Carpool Request (2 names max)
*
WAIVER OF LIABILITY: I release Puck Cancer & Rocket Ice Arena including tournament supporters, staff, officials, and volunteers, from any liabilities of any nature whatsoever for any loss, damage, expense or injury, including death which may be suffered, directly or indirectly, by a Team player, Team coach, Team official or Team invitee if any arising in connection with participation in or attendance at the tournament. I am aware that photographs will be taken during Puck Cancer events and may be displayed on Puck Cancer website and will be available for tournament participants.
Parent Electronic Signature
*
Once "Submit" is clicked you will be directed to a payment page.
Submit
