Individual Tryout RegistrationFields marked with an * are required.error_outline Some fields contain errors Show {{form.showErrors ? 'Less' : 'More'}}keyboard_arrow_down {{error.field}} - {{error.message}} TryoutPennsylvania State Tryouts (March 21st @ NE Raquet Club)New Jersey State Tryouts (March 21st @ NE Raquet Club)North Carolina State Tryouts (April 4th @ XL Sports World)Ontario Provincial Tryouts (April 17th-19th @ Maple Grove Arena)Illinois State Tryouts (April 27th @ Sale Creek Sports Center)Missouri State Tryouts (May 2nd-3rd @ All American)Southern California State Tryouts (May 2nd-3rd @ Corona Inline/HB Inline)Tennessee State Tryouts (May 6th @ Hendersonville)Michigan State Tryouts (May 8th-10th @ JCC)First NameLast NameLast Name as it will appear on jerseys (In all CAPS)EmailCell Phone #CityStateAlabamaAlaskaArizonaArkansasCalifornia (North)California (South)ColoradoDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingBirth Year20152014201320122011201020092008200720062005200420032002GenderMaleFemalePositionFDF/DGPractice Jersey SizeYouthS/ML/XLGoalie CutPants SizeJr SmJr MdJr LgAd SmAd MdAd LgAd XlTeam Jersey SizeYSMYMDYLGYXLAXSASMAMDALGXXLAXLXXXAd Goalie Cut (size 58)Jersey # Choice 11-2 digitsJersey # Choice 21-2 digitsJersey # Choice 31-2 digitsSkill Level Trying Out ForAAA/AA OnlyAAA/AA or ADo you play ice hockey?YesNoName of current roller hockey club (if any)Waiver2020 Minor WaiverParent/Guardian NameFirst NameLast NameAgree I agree to the above waiver.Sign your name if you agree with the above waiverFull NameSignarrow_drop_downGenerate from nameclearLoad signature fontTryout FeesTryout FeePrice$70.00Would you like to donate to Senior Team USA?AmountThank you!PaymentCouponApplyDiscountSubtotalTaxTotal USDContinue to PayPalThe form has been submitted.