A > 2022-2023 > REP > U14 AA (Minor Bantam) > U14 (Minor Bantam) Tryouts

U14 (Minor Bantam) Tryouts - Contact Form, U14 AA (Minor Bantam), REP, 2022-2023, A (Tecumseh-Shoreline Eagles)

U14 (Minor Bantam) Tryouts - Contact Form

Please fill out the form completely!

Fill out both parent/guardian contacts as well as phone numbers and email addresses for further correspondence

Player Information

Please fill out completely

First Name^*

Required

Eg: John

Last Name^*

Required

Eg: Doe

Address^*

Required

City^*

Required

Postal Code^*

Required

Eg: XXX-XXX

Home Phone^*

Required

Example: ###-###-####

Date Of Birth^*

Required

Do you have any interest in participating in "Summer Skates"^*

YesNo

Required

This is not mandatory to attend, just trying to gauge interest

Any allergies or medical information we should be aware of?

Concussions, pre-existing injuries, medications, etc

Are you currently able to cross the USA land border without restrictions?^*

Yes
No
Prefer not to disclose

Required

Eg: Legal Issue, COVID vaccinations etc

Primary Parent/Guardian Info

First Name^*

Required

Eg: John

Last Name^*

Required

Eg: Doe

Address (if different from player)

Home Phone^*

Required

Example: ###-###-####

Cell Phone^*

Required

Example: ###-###-####

Email Address^*

Required

Example: [email protected]

Secondary Parent/Guardian Info

First Name^*

Required

Eg: John

Last Name^*

Required

Eg: Doe

Address (if different from player)

Home Phone^*

Required

Example: ###-###-####

Cell Phone^*

Required

Example: ###-###-####

Email Address^*

Required

Example: [email protected]

U14 (Minor Bantam) Tryouts - Contact Form, U14 AA (Minor Bantam), REP, 2022-2023, A (Tecumseh-Shoreline Eagles)

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Primary Parent/Guardian Info

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