2018-19 Riverton Ice Hockey Player Registration Form
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USA Hockey Player Number
This is a 9 digit number, followed by the first 5 letters of the last name. You will receive it after finishing your registration through the USA Hockey Website:
Player First Name
Player Last Name
State / Province / Region
Parent/Guardian Names and Phone Numbers
Please include phone numbers so the coaches know who to contact.
This is to certify that on this date, I as a parent or guardian give my consent to USA Hockey and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for the above mentioned participant for any injury that could arise from participation in USA Hockey sanctioned events.
Please check if Athlete has had any of the following:
Athlete has had recent tetnus booster
Athlete has been placed on activity restriction by doctor
Please list any allergies and medications
Has the Player ever been registered with another Hockey Association in Wyoming? If yes, please list the Association here, otherwise just answer No.
Failure to disclose previous registration will result in the player being ineligible to play in the WAHL league for the current season.
By checking the box below, I agree that if any RIHA equipment or uniforms are rented or assigned to above player, I will return them at the end of the season, and I agree that if items are not returned I will be billed for their replacement.
Send me a copy of my responses.
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