Hockey HQ - Pond Hockey Registration
For Ages 8-12 * Oct. - Mar - 20 games - $420.00
Full Name
*
First Name
Last Name
Birthdate
*
m/d/year
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Prior Pond Hockey Team with Summit Centre
*
If Applicable
Skating Ability
*
If Applicable
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Numebr
*
-
Area Code
Phone Number
Relationship to Participant
*
Submit Form
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