HOLY LENAPE VALLEY
ICE HOCKEY
Fall 2017 PLAYER REGISTRATION
PLEASE PRINT
Player’s Name
Address
Player’s Email Address
Sex
Grade
Date of Birth
Phone #
High School (2017/18 School Year)
Position
Mother’s Name
Forward
Father’s Name
Defense
Mother’s email Address
Father’s email Address
Mother’s Ph#
Father’s Ph#
Goalie
USA Hockey#
Season Participation
Fall 2017/18 Season
$1050.00*
*3 Payments of $350. Due dates are June 6, July 6, and September 6 2017.
The June 6th Payment of $350 is the required deposit and reserves a spot
for team try outs (date to be announced).
**We are offering a $100 discount for total balances paid in full by July 1
($1050 total)
HLV Registration Form Fall 2017
HOLY LENAPE VALLEY
ICE HOCKEY
Fall 2017 PLAYER REGISTRATION
*** Uniform costs not included
$150 Multi Player discount if family has 2nd or 3rd child playing HLV Hockey
Club this year
Checks are made out to HLV/RV Ice Hockey Club
Payments should be mailed to:
HLV Ice Hockey Club
PO Box 654
Lumberton, NJ 08048
Note: Any returned checks will result in the family having to pay in cash and also the bank fee the club will be
charged.
HLV Registration Form Fall 2017