2009 - 2010 Season Registration

Extra Notes

• PAYMENTS can be given to any board member or sent to the following address:
  Viaero Event Center
  609 Platte Rd
  Kearney, NE 68845
  Attn-TCSHL-Jim Kettner

League Season Registration Form

* ~ Required Fields

Personal Information

First Name: * Last Name: *

Address 1: *

Address 2:

City: * State: * Zip: *

Email:

Home Phone:

Work Phone:

Cell Phone:

League Memberships

• TCSHL - Tri-City Senior Hockey League
• D.R.I.L. - Developmental Recreational Introduction to Hockey League

I want to play in the TCSHL only.

I want to play in D.R.I.L. only.

I want to play in both D.R.I.L. and the TCSHL!

Positions (Check All That Apply)

Goalie Defense Center Wing

Jersey Information

L XL XXL Goalie

Jersey Number (Choose three numbers, between 0-99, with choice number 1 being the number you would most like to have.)
Choice 1: Choice 2: Choice 3:

Skill Level

Newbie (Less than 1 year experience, new skating, stick, etc skills)

Beginner (Decent forward skating, lower backward skate & stick skills, grasp of game)

Intermediate (Good forward movement, decent backward, good all around medium skill)

Advanced (Front/back skating proficient, good skills but can't move puck end to end alone)

Elite (All skating, shooting, passing skills available, extensive playing background)

Will you sub for other teams? (If yes, select best night(s). Does not apply to DRIL.)

Yes No

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

If you will be traveling and will be doing so with other player(s), list them here:

Miscellaneous

Are you interested in being a Team Rep? Does not apply to DRIL. Yes No

Are you interested in being a referee? Does not apply to DRIL. Yes No

• Refunds: All refunds must be reviewed and approved by the TCSHL Board.

Payment Option

Plan I - 1 Installment. One payment of $120.00. TOTAL = $120.00

Additional Notes

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