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PLAYER REGISTRATION FORM
First name
Last name
Age
DOB
School
Grade
Team Registering For
Skater or Goalie?
Skater
Goalie
USA Hockey Number
Parent Name
Email
Phone Number
Home Address
City
State
Zip Code
Medical Insurance Company
Does your player have any health concerns we should be aware of?
Yes
No
If so, what?
Will you be applying for financial aid?
Yes
No
Will you be paying in installments?
Yes
No
REGISTRATION PAYMENT
10/12U Full Registration - $2591.62
14U Full Registration - $2591.62
16U Full Registration - $2333.12
19U Full Registration - $2077.13
Payment Plan Deposit - $518.52
Financial Aid - $0
Uniform Number Preference ( Pick 3)
Uni Size
Sock Size
I accept terms & conditions of the Wolverines Hockey Club and USA Hockey Code of Conduct
I accept terms & conditions of the 75 Sport Co. Liability Waiver
I read and accept terms & conditions of USA Hockey HEADS UP Concussion Waiver and SafeSport Commitment Training.
I accept terms & conditions of the Wolverines Hockey Club financial policy.
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