subject_line
SQUIRT (10U) / PEE WEE (12U) CLINICS REGISTRATION
Player Profile
First Name
*
Last Name
*
Gender
*
M
F
N/A
Team/Organization?
*
Age Group?
*
Mite
Squirt
Pee Wee
Level
*
AAA
AA
A
B
House
JR
Position
*
W/C
D
G
Contact Information
Street Address
*
Address Line 2
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone Number
*
Email Address
*
Squirt/Pee Wee Session Date Selection(s)
Session Dates
*
May 17
(7 remaining)
May 24
(8 remaining)
May 31
(9 remaining)
June 7
(8 remaining)
June 14
(8 remaining)
June 21
(11 remaining)
June 28
(12 remaining)
July 5
(12 remaining)
July 12
(14 remaining)
July 19
(11 remaining)
July 26
(19 remaining)
August 2
(15 remaining)
Session Dates (Goalies)
*
May 17
(4 remaining)
May 24
(2 remaining)
May 31
(2 remaining)
June 7
(2 remaining)
June 14
(3 remaining)
June 21
(3 remaining)
June 28
(3 remaining)
July 5
(3 remaining)
July 12
(4 remaining)
July 19
(3 remaining)
July 26
(3 remaining)
August 2
(4 remaining)
Current Total:
$0.00
Calculate
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