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Player Name
*
First Name
Last Name
Birth Year
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Experience Level
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Never Played Hockey Before
Some Experience
Played on a Recreation/In House Team
Played on a Club Team
Parent Name
*
Parent Phone
*
Please enter a valid phone number.
Parent Email
*
example@example.com
Location
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Riverside
Westminster
Carlsbad
What programs are you interested in:
*
Club Hockey
Spring Hockey
Girls Hockey
Hockey Lessons
How did you hear about us?
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Please Select
Website
Social Media Ad
Newsletter
Referral/Word of Mouth
School Flyer
Girl/Boy Scouts
YELP
Kids Out and About In OC
ActivityHero
Groupon
ValPak/Clip.com
Google Search
Other
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