Great Neck Floor Hockey Registration – 5 Towns Hockey League

Name(Required)

First Last

Grade(Required)

School(Required)

T-Shirt Size(Required)

Participant can play goalie? - Please realize this is a season long commitment.(Required)

Has the participant played in an organized hockey league before?(Required)

Parent 1 Name(Required)

First

Parent 2 Name

First

Parent 1 Cell(Required)

Parent 2 Cell

Parent 1 Email(Required)

Parent 2 Email

Home Phone(Required)

Address(Required)

Street Address City State ZIP Code

Liability Waiver(Required)

Agree

I acknowledge that my son assumes all risks of being injured while participating in the YI of Great Neck Floor Hockey League and I agree to hold the YI of Great Neck Floor Hockey League and the 5 Towns Sports League, their officials, coordinators and all other staff, harmless from any liability, loss, or personal expense arising from my son's participation in the league. I have read and agreed to the terms stated in this application.

Registration Agreement(Required)

Agree

The cost of League Registration is $250 + $10 processing fee if paying with a credit card. There will be a form to pay with credit card after you complete this application form. If you would like to pay by Zelle, the fee is $250. Zelle to [email protected] Once the application is filled out completely and uploaded, and payment is received, we will consider your child registered. Please be aware all Registration Fees are Non Refundable

Payment Method(Required)

Registration Cost

Price:

Registration Cost

Price:

Credit Card

Card Details

Cardholder Name

CAPTCHA