Jr Reign Player Application Form
Please fill out this form so our Coaching Staff can evaluate your player to see if you are the right fit for our program and if we are the right fit for you and your goals.
Player Name
*
First Name
Last Name
Player Birth Year (i.e 2005)
*
Birth Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Player Birth Year
Please Select
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
Player Email (optional for older players)
example@example.com
Player Phone Number (optional for older players)
Format: (000) 000-0000.
Parent Name
*
First Name
Last Name
Parent Email
*
example@example.com
Parent Phone Number
*
Format: (000) 000-0000.
Team and Age group played last season (i.e Jr Reign 16U)
*
Level you played last season
*
Varsity, JV, AAA, AA, A, B
Team and level interested in trying out for this season
*
example: 8UA, 12UB, 14UAA, 18UAAA, etc.
Position
*
D
F
D/F
G
Height
Weight
Season Interested in (select all that apply)
*
Fall/Club Season (August to March)
Spring Season (March to June)
Summer Season (June to August)
Short Bio and why you want to play for the team(s) selected above:
*
If new to the Jr. Reign and possible, Please submit Video clip or game highlight so we can better evaluate the player.
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Which Location would you be interested in attending when the program begins (check all that apply)
*
Riverside
Gender
*
Female
Male
References if applicable (add Name, Phone number and email)
How did you hear about this application?
*
Additional Comments
How did you hear about us?
*
Please Select
Referred by (Enter name in comments)
Websites
Google Search
Social Media
Coach (Enter name in Comments)
Flyer in rink
Additional Comments
Submit
Should be Empty: