2014 Birmingham Rangers White Tryout Registration
Please fill in the form below. Contact birminghamrangerswhite@gmail.com with questions.
Player Name
*
First Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
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25
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27
28
29
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31
Day
Please select a year
2015
2014
Year
City of Residence/District
*
Position
*
Forward
Defense
Forward or Defense
Goalie
Shoots
*
Right
Left
What team did you play on last season?
*
Which Tryouts Will You Attend? (Select all that apply)
*
Tues March 17
Thurs March 19
Sat March 21
Are you willing to accept if offered a spot on this team?
*
Yes
No thanks, I'm only here for the skate
Not sure yet
Parent Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Questions or comments
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