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PHA Registration and Waiver Form
This form must be completed prior to participation in any PHA activity.
* Required
Player's First Name
*
Your answer
Player's Last Name
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Zip Code
*
Your answer
Team Name
*
Choose
Beginner School
Free Agent
Angry Penguins
Bonecurshers
Brewski's
Chosen Few
Dragons
Ice Badgers
Ice Gators
Invaders
Jackalopes
Long Shots
No Regretzsky's
Piranhas
Polar Bears
War Boys
Warriors
Yellow Jackets
Other
Email address
*
Your answer
Cell Phone
*
Your answer
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