REGISTRATION FOR FARM TOUGH HOCKEY

Camps, Clinics, and Programs

Registration

Registration for REC League Ages 6-12

REC League 2020

REC League 2020 April 5 - June 7 All games on Sunday 1pm - 5pm Ozaukee Ice Center 5505 Pioneer Rd, Mequon, WI 53097 262-375-6851

Name*
First Last
Age*
Birth Date*
MM
DD
YYYY
Email*
Phone
Address
Street Address Address Line 2 City State ZIP Code
Do you play ice hockey?*
- Yes
- No
If yes, what organization and what team did you play on this year? (Example: Waukesha Pee Wee C)
If no, would you rate yourself as a beginner or intermediate player?
Comment
Include any comments or questions regarding the clinic, camp, or program.
Liability Waiver*
- Yes
I have read and agree to the liability waiver and terms and conditions.
Parent or Legal Guardian*
Jersey Size*
Program Registration Fee*
Price: $169.00
Fee includes a Farm Tough REC league jersey!
Payment*
- Pay by Check
- Pay by Credit Card
- Pay by Venmo - Peter-Dale-10
Please choose if you wish to pay by check or credit card. If you pay by check, note that your spot is not reserved until payment is received. Payment should be mailed to: Peter J Dale LLC PO Box 674, Pewaukee, WI 53072
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

The Form below is to register for the Adult REC League on Sunday evenings.

If you are interested in participating in the Wednesday Competitive League, please email Peter@farmtoughhockey.com.

Adult League

Adult League April 7 - June 9, 2019 All games on Sundays 5pm - 7pm This league is for competitive players Ozaukee Ice Center 5505 Pioneer Rd, Mequon, WI 53097 262-375-6581

Name*
First Last
Birth Date*
MM
DD
YYYY
Email*
Phone
Address
Street Address Address Line 2 City State ZIP Code
Do you play ice hockey?*
- Yes
- No
If yes, what organization and what team did you play on this year? (Example: Waukesha Pee Wee C)
If no, would you rate yourself as a beginner or intermediate player?
Comment
Include any comments or questions regarding the clinic, camp, or program.
Liability Waiver*
- Yes
I have read and agree to the liability waiver and terms and conditions.
Parent or Legal Guardian*
Jersey Size*
Program Registration Fee*
Price: $169.00
Fee includes a Farm Tough REC league jersey!
Payment*
- Pay by Check
- Pay by Credit Card
- Pay by Venmo - Peter-Dale-10
Please choose if you wish to pay by check or credit card. If you pay by check, note that your spot is not reserved until payment is received. Payment should be mailed to: Peter J Dale LLC PO Box 674, Pewaukee, WI 53072
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

REGISTRATION FOR FARM TOUGH HOCKEY

Registration

College Prospect Skater 2020

College Prospect Goalie 2020

REC League 2020

Adult League

January 2020
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