KHS Ice Arena Little Ducks Hockey Initiation – 10 to 12 Registration Portal

Player Information

Name*

First Name

Last Name

USA Hockey Membership Number*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Gender*

Boy Girl

Birthdate*

Note: Children who have previously participated in a youth hockey program or association are not eligible to participate in Little Ducks Hockey Initiation. Discovery of participation will result in removal from the program without refund

My child is in good physical condition, is physically fit to participate in the Hockey Initiation program and is not subject to any medical condition that poses or may pose any risk of harm or disability. I understand it is recommended that my child have ice skating experience before starting the Hockey Initiation program.

Parent Information

Name*

First Name

Last Name

Relationship*

Mother Father Guardian

Email*

Phone*

Available Sessions (Cost is $180 per session)*

Next session TBD

1

180

Total $

Payment Information

Credit Card*