Youth Registration Name* Parent Name (if under 18) Address City, State, Zip Phone* E-mail* Date of Birth* CHOOSE YOUR LEAGUE* Learn to Play Program (4 to 7) Penguin (5-9) Beaver (10-12) Cadet (13-15) Freshman (15-19) Adult League (18+) King of the Dek (35+) Draft Tournament (special event) Click to select 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. If you are signing up from a school flyer please list the school. Goalie No Yes, Full Time (All full time goalies play for FREE, as long as there are roster spots) 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 Submit Note: We will email you closer to the start of the season.