Team Registration Form

Please complete and submit this form using the Submit link at the bottom of this page. Ensure payment is received no later than February 1, 2010 for MIT February 2010 and June 1, 2010 for MIT June 2010.

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Late fees apply if registration and payment is made after these respective dates for each event.

Note: All fields are required.

1. General Information

Team Name:

Head Coach Name:

Home Address:

City:

State:

Zip Code:

Home Phone:

Work Phone:

Cell Phone:

Email Address:

Assistant Coach Name:

Assistant Coach Name:

2. Team Registration

Please select one of the following age groups:

8 and Under

9 and Under

10 and Under

11 and Under

12 and Under

13 and Under

14 and Under

15 and Under

16 and Under

17 and Under

Team Roster:

 

Last Name

First Name

MI

Date of Birth
mm/dd/yy

Grade
Exception

Jersey Number

1.

Yes

No

2.

Yes

No

3.

Yes

No

4.

Yes

No

5.

Yes

No

6.

Yes

No

7.

Yes

No

8.

Yes

No

9.

Yes

No

10.

Yes

No

11.

Yes

No

12.

Yes

No

13.

Yes

No

14.

Yes

No

15.

Yes

No