Elmira Hockey Club: Modified Team
Interest Form
Player Name
*
First Name
Last Name
Player Birth Year & School Year
*
Ex. 2026 - 7th Grade
School Attending:
*
Horseheads Middle School
Player Level/Organization Playing for:
*
12u Snowbelt - Jr Aviators
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
E-mail
*
example@example.com
Practice Availability: (Weekdays that Work the Best, Practice once a week)
*
Ex: Tuesday & Thursday
Practice Time: (Time that Works the Best)
*
Ex: 5pm-7pm
Comments/Questions:
Learn More About Elmira Hockey Club
www.elmirahockeyclub.com
Submit
Should be Empty: