Exceptional Player Advancement Application — Rep Hockey
Complete this application as the parent or legal guardian to request consideration under the AMHA policy by August 15.
Player Information
Player's Full Name
*
First Name
Last Name
Player's Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Current Age Division
*
Please Select
U11
U13
U15
U18
Current Team
*
Parent/Guardian Information
Parent/Guardian Full Name
*
First Name
Last Name
Relationship to Player
*
Please Select
Mother
Father
Legal Guardian
Other
Contact Email
*
example@example.com
Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Advancement Request Details
Requested Age Division for Advancement
*
U13
U15
U18
Other
If Other, please specify the requested division
*
Has the player previously played with older age groups or divisions?
*
Yes
No
If yes, please describe the experience
*
Reason for Advancement Request (please explain why you believe your player is an exceptional candidate for advancement)
*
Additional Information (optional)
Parent/Guardian Acknowledgements
I acknowledge that submitting this application does not guarantee acceptance into evaluations or approval to participate in a higher age division.
*
I acknowledge
I confirm that I am the parent or legal guardian of the player named above and that all information provided is accurate to the best of my knowledge.
*
I confirm
I understand that the AMHA reserves the right to request additional documentation or information as part of the review process.
*
I understand
Parent/Guardian Signature
Parent/Guardian Electronic Signature
*
Printed Name of Parent/Guardian
*
First Name
Last Name
Date Signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Application
Submit Application
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