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SKILLS ➜ CONFIDENCE ➜ SUCCESS
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Registration Form
Step 1
To register, please take the time to fill out the information below.
Student First Name
Student Last Name
Date of Birth
Session #
*
022 (Hazel Park, 8/2-8/5)
Position
*
Skater
Goalie (No Charge)
Parent First Name
Parent Last Name
Second Parent (Optional)
Phone Number
Parent Email
Address/City/State/Zip
Emergency Contact
Emergency Phone Number
Medical/Allergies Concerns
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