Roller Club Registration

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?
Did you play club last season?*
- Yes
- No
Jersey Number Preference; Please choose 3 numbers*
List three numbers separated by commas.
2020 Scheduled Tournaments*
- Yes
March 27-29: TORHS Winter Cup in Chicago - All Teamns
April 24-26: Midwest Wars in Chicago - Red Teams
May 1-3: Cinco de Mayo in Des Moines IA - Black Teams/Less Experienced Teams
May 15-17: NARCh Qualifier in Mequon, WI - All Teams
June 5-7: TORHS Qualifier in Chicago - All Teams
Nationals
NARCh Florida: June 19-28 - TBD
TORHS Florida: June 29-July 8 - TBD
By checking the box I confirm that I am able to attend all of the scheduled tournaments.
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*