1. NorCal Extreme
PLAYER INFORMATION
Name: Last _____________________ First __________________ MI _____
Address:
Street _______________________
City _______________________ e-mail:_________________________
Zip _______________________ Cell ( ) -
Date of Birth: __________________ Age: __________ M F
(circle one)
AAU Hockey membership number (insurance) _________ Expiration Date _________
Jersey Size: Adult : XL L M S Numbers (preferred) ____
____ _____
Youth: L M S
Goalie: XXXL XXL XL
Pant Size: Adult : XL L M S
Youth: L M S
PARENT/GUARDIAN INFORMATION
Mother/Guardian: ___________________ Father/Guardian: _________________
Address:
Street _______________________ Street__________________________
City _______________________ City __________________________
Zip _______________________ Zip __________________________
Phone:
Home ( ) - Home ( ) -
Work ( ) - Work ( ) -
Cell ( ) - Cell ( ) -
e-mail: _______________________ e-mail: _______________________