2022 Rink Hockey National Championships- Team Entry Form

2022 Rink Hockey National Championships- Team Entry Form

July 16-July 23: Lincoln, NE: Speedway Village
Event Website- https://www.teamusa.org/USA-Roller-Sports/Events/2022/July/02/2022-Indoor-National-Championships

Lincoln CVB- https://www.lincoln.org/

Speedway Village Website- https://speedwaysportscomplex.com/
ONLY ONE (1) TEAM MAY ENTER PER FORM.

ENTRY FEE - $550 PER TEAM FOR UP TO TEN (10) PLAYERS. A $85 PER PLAYER FEE IS ASSESSED TO ANY TEAM OVER THE MAXIMUM PLAYER AMOUNT.

TEAM REGISTATION DEADLINE – RECEIVED BY JUNE 24, 2022

- NO REGISTRATIONS WILL BE ACCEPTED AFTER THE DEADLINE.

MEMBERSHIP REGISTRATION DEADLINE- REGISTERED ONLINE BY JULY 1, 2022

- ALL PLAYERS & COACHES MUST BE CURRENT MEMBERS BY THIS DATE
Club and Team Name *
Club ID Number *
Coach Name *
Team Captain Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please Select the appropriate Division- All youth divisions will be Coed *

8U 10U 12U 15U 18U Masters- Men age- 40+/Ladies age- 30+/Goal Tender age- 35+/ No Gold division players SR Bronze SR Silver SR World Class SR Ladies
Email *
example@example.com
Phone Number *
Please enter a valid phone number.
Team Roster- Please list Player Name- Positon Playing - and Jersey number if known *

My Products *

Rink Hockey Nationals Team Entry fee

$ 550.00

Total

$ 0.00