*Required Fields
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You must register with USA Hockey prior to registering with JAHL. Your confirmation number is required to submit and will be double checked at registration. You may be asked with by the JAHL to show proof without notice. The 2011-2012 form may not be available on USA Hockey Site when you register. Make sure you are using the correct year. If the correct form is not available, put "NA" in the USA conformation field and we WILL ask for proof later!</p><p>
If you pay online, you will be charged an additional fee that is figured in to the price of your payment. This is to cover the cost of accepting credit cards. Full payment is required. If you have any questions please send an email to info@jahl.us
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If you include your email address on this form, you will receive a copy of it in your email box.

If you are using this page on 9/18/11, please print out your USA Hockey Conformation, your JAHL Registration before you submit and your payment conformation. Without these you will have to reregister and repay or you will not play on opening night.
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JAHL Registration Form
Your Name* *
Your Email Address
Street Address* *
City, State, Zip Code* *
Home Phone* *
Cell Phone
Team You Play For
Second Team You Play For
League* *
 Open League (18+) 
 Over League (Over 30) 
 Both 
New Player* *
 Yes 
 No 
Change Team* *
 Yes 
 No 
Payment*
 Credit Card only accepted at this time  
USA Hockey Confirmation Number* *
Insurance Company Name* *
Address of Insurance Company* *
Policy Number* *
Birthdate
Emergency Contact name
Relationship
Phone
Physician's Name
Physician's Phone
Hospital of Choice
ALL ICE PAYMENTS MUST BE KEPT UP TO DATE.
Your captain will be notified if your payments are not current and you will not be permitted to play until they are up to date. If there is a specific problem that the league should be aware of, you should contact Paul Demler @ 664-7442.
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JAHL
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