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* Indicates Required Field

Player Information-

Are you a returning Player?

Yes No

First Name *

Last Name *

Birthdate *

Access Code

(Only returning players need to enter the Access Code.)

Email Address *

Position *

Address *

City / Hometown *

Province *

Phone Number *

League *

If you know what team you would like to be added to, please select the league (if applicable) and or team.

What is your Jersey #?