Player First Name
Player Last Name
Player Birth Date
January
February
March
April
May
June
July
August
September
October
November
December
Month
1
2
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31
Day
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
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1928
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1924
1923
1922
1921
1920
Year
USA Hockey NUMBER
Level you are evaluating for
Squirt
PeeWee
Team(s) Last Season
Level played last season
Position Played
Forward, Defense, Either, Goalie
Have you evaluated for any other team for the 2020/21 Hockey Season
Yes or No
Father's Name
Parent Contact Phone Number
-
Area Code
Phone Number
Parent Contact E-mail
Mother's Name
Parent Contact Phone Number
-
Area Code
Phone Number
Parent Contact Email
example@example.com
Parent Contact Email
Street Address
City
State
Zip Code
Jersey Number
Referred By
Please provide the players name who referred you to the Senators Organization
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