Individual Registration – North Hills Dek Hockey

Name*

Parent Name (if under 18)

Address

City, State, Zip

Phone*

E-mail*

Date of Birth*

CHOOSE YOUR LEAGUE*

Names of players you prefer to play with(up to 2), also any days that do NOT work for your child

T-Shirt Size and Suggested Player Numbers: YS, YM, YL, AS, AM, AL, AXL, A2XL*

If this is your first time playing at either Cranberry Dek or North Hills Dek, do you have a referral? You don't need to have one, but they get a bonus 😉

Goalie

No
Yes, Full Time
Yes, Part Time

Coaching (Youth League Only)

Not interested
Yes, Head Coach and or Assistant Coach
Yes, Assistant Coach Only

As the legal guardian of the child I am registering, I understand the inherent risk of not wearing a mask and being out in public. I understand that we are participating at our own risk and will not hold North Hills Dek Hockey liable if we contract the virus

Yes, I agree
No

Note: If you do not receive an e-mail copy of the registration within a few minutes, please check your spam folder.