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'05 Rebels Fall Tryout 2016/2017
Please fill out this form prior to arriving at the rink.
Sunday June 5th - 7:30pm
Kensington Valley Ice House - Brighton
All Players $15.
Player's Name
*
First
Last
Birthdate
*
MM
/
DD
/
YYYY
Position
*
Please select
Forward
Defense
Goalie
Shoots
*
Left
Right
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Where did you play this spring (2016)?
*
Where did you play last fall (2015/16)?
*
Parent 1
*
First
Last
Phone
*
###
-
###
-
####
Email
*
Parent 2
First
Last
Phone
###
-
###
-
####
Email
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