NorthEast Elite Field Hockey - Player Info. Form

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PLEASE FILL OUT THE BELOW INFORMATION TO REGISTER FOR 2022 SPRING/SUMMER SEASON

A waiver will be emailed by before your first program to all 2022 registered athletes.

Please bring the signed waiver to our first session.

Name Prefix

First Name *

Last Name *

Address Type

Address Country

Address 1 *

Address 2

City *

State

Zip Code *

Comments

Email Type 1

Player Email *

Phone Type

Phone Country

Player Phone *

Phone Extension

DOB *

Age

Current School

HS Grad Year

Position *

FORWARD	MID FIELD
DEFENSE	GOALIE

Email Type

Parent Email *

Phone Type 1

Phone Country 1

Parent Phone *

Phone Extension 1

Emergency Contact

Phone Type 2

Phone Country 2

Emergency Phone *

Phone Extension 2

Upload Waiver/Release

Comments

Select Program *

"Care more than others think is wise, risk more than others think is safe, dream more than others think is practical,

and expect more than others think is possible" - Claude Bissell