General Interest Form for ALL (10.2023)

I’m interested in learning more about the East Coast Jumbos
Interested in becoming a/an*

PlayerOn-Ice VolunteerOff-Ice VolunteerOther
Potential Participants Name*

First NameLast Name
Potential Participants age
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
example@example.com
Mobile phone number*
Parent/Guardian/Emergency Contact Name*
Parent/Guardian/Emergency Contact Phone number*
Please enter a valid phone number.
In 2-3 sentences, HOW do you want to participate with the East Coast Jumbos? (Coach, Volunteer, Player, Other)*
In 2-3 sentences, WHY do you want to participate with the East Coast Jumbos? *
How did you hear about the East Coast Jumbos?*
What is your past experience playing hockey and/or skating?*
Reference Number One - No Parent or Relative references please*

First NameLast Name
Describe how you know this person (Teacher, Coach, Supervisor, etc.)*
Reference Number One Email
example@example.com
Reference Number One Phone #*
Please enter a valid phone number.
Reference Number Two - No Parent or Relative references please*

First NameLast Name
Describe how you know this person (Teacher, Coach, Supervisor, etc.)*
Reference Number Two Email
example@example.com
Reference Number Two Phone #*
Please enter a valid phone number.
USA Hockey number (if available) - ALL PARTICIPANTS WILL BE REQUIRED TO REGISTER WITH USA HOCKEY PRIOR TO SKATING OR VOLUNTEERING WITH US
Any other questions or info you would like to share or want us to know?*
Once form is completed it will be reviewed and you will be contacted by our Head Coach to discuss our organization and potential options.

Thank you for your interest in the East Coast Jumbos.
Should be Empty:

I’m interested in learning more about the East Coast Jumbos