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 playing dek hockey and that injuries may occur on and off the dek. I agree to not hold North Hills Dek Hockey liable for any accidents or incidents that may occur.

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.