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PHA Registration and Waiver Form 2021-22
This form must be completed prior to participation in any PHA activity.
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* Indicates required question
Player's First Name
*
Your answer
Player's Last Name
*
Your answer
Team Name
*
Choose
Beginner School
Free Agent
Angry Penguins
Titans
Dragons
Ice Badgers
Invaders
Jackalopes
No Regretzsky's
Piranhas
Warriors
Yellow Jackets
Other
Position
*
Forward/Defense
Goalie
Email address
*
Your answer
Cell Phone
*
Your answer
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