Elite Registration – Cranberry 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*

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 Cranberry Dek Hockey liable for any accidents or incidents that may occur.

Yes, I agree
No