Hockey Coach & Asst Coach application
Join us in providing ALL Metro Chicago youth the opportunity to experience the thrill of participating in ice sports in a fun, safe, positive and inclusive environment regardless of race, color, religion, national origin, gender and socio-economic status.
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Email *
First Name *
Last Name *
Gender *
Date of Birth
Marital Status *
Street Address *
Apt, Suite, Building Number
City *
State (example: IL) *
Postal/Zip Code (5 digit) *
Cell Phone (format: 312-555-5555) *
Please list your handle/username for your personal social media accounts such as facebook, instagram, twitter, LinkedIn, TikTok, YouTube, etc.
Please provide information on who you'd like us to contact in case of an emergency.
Emergency Contact Name (first and last) *
Emergency Contact Phone Number (format: 312-555-5555) *
Emergency Contact relation to you *
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