2023 Individual Tryout Registration

Individual Tryout Registration

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First Name

Last Name

Last Name as it will appear on jerseys (In all CAPS)

Cell Phone #

City

Height

(ex. 5-1)

Weight

(ex. 125)

Jersey # Choice 1

1-2 digits

Jersey # Choice 2

1-2 digits

Jersey # Choice 3

1-2 digits

Name of current roller hockey club (if any)

Waiver

2023 Waiver

Parent/Guardian Name

First Name

Last Name

Agree

I agree to the above waiver.

Sign your name if you agree with the above waiver

Full Name

Sign

Tryout Fees

Tryout Fee

Select

***female players receive 1 extra year of eligibility. All female players should enter their actual birth year and we will automatically enter them in the proper tryout age group. If they do not want to take advantage of the extra year of eligibility and only tryout with their actual birth year, jus please email us and let us know that***

Payment

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Discount

Subtotal

Tax

Total USD

Individual Tryout Registration

Waiver

Tryout Fees

Payment

The form has been submitted.

Content

2023 Individual Tryout Registration

Waiver

Tryout Fees

Payment

The form has been submitted.

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