MINI MINUTES - Spring 2018 Registration
Free Youth Field Hockey Program: April 3, 10, 17 & 24, 2018 from 5:30-6:30pm @UMass Field Hockey Field

Please complete the following information to register your child for the Spring Mini Minutes Program. The program is open to boys and girls from ages 5 through 13. There is no charge to participate in the program, but space is limited to 140 participants and will be filled on a first-come, first-serve basis. If you have any further questions email : wmasshky@gmail.com

PARTICIPANT INFORMATION
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Address (Street Address, City, State, Zip) *
Your answer
School Name *
Your answer
School Grade *
Your answer
PARENT/GUARDIAN #1
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone # *
Your answer
PARENT/GUARDIAN #2 (OPTIONAL)
First Name
Your answer
Last Name
Your answer
Email Address
Your answer
Phone #
Your answer
ADDITIONAL INFORMATION
Any friends your child would like to have on their team?
Your answer
Any special needs that we should know about?
Your answer
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