LONG ISLAND REBELS / HAWKS / LADY ISLANDERS TRYOUT INFORMATION
LONG ISLAND REBELS / HAWKS / LADY ISLANDERS TRYOUT INFO
Email address *
Players Last Name *
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Players First Name *
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Players Year of Birth / Select One *
Home Address *
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Town *
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Home Zip Code *
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Players Email *
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Parents Names *
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Parent Cell Phone Number *
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Parent E-mail
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Team You Played for Last Season *
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Position Played *
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Did You Obtain a Release from Rebels or Any Other Team *
What Organization and Team is the Release from
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I understand that if I have a release I must bring the original release with me to the first tryout.
I/We the parent(s) or legal guardians of the above named player give my / our consent for the participation in all the activities of the Long Island Rebels and further claim that he / she (player) is in perfect physical condition to participate in the tryout process and coming season. I / we assume all risks and hazards incidental to such participation and waive, release, absolve and agree to hold harmless the Long Island Rebels Youth Hockey Assn, Associated Organizations, sponsors, supervisors, participants and board members for any claim arising out of an injury to my son / daughter. I / we acknowledge that as per Long Island Amateur Hockey League rules our son/daughter may only tryout for one team at a time. *
Tryout Payment
TRYOUT FEES *
Prepaid discount ends 7 days prior to first tryout, within 7 days tryout fee increases by $25
Mail Check To: Long Island Rebels, . P.O. Box 1041 Huntington, NY 11743
IF PAYING BY CHECK SKIP CREDIT CARD ENTRIES TO BOTTOM OF PAGE AND CLICK ON SUBMIT
Name on Card
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Mailing address of card
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Card Number
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Card Expiration Date
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CCV Code
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