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High School Boys

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Squirt

Mite - Boys & Girls

High School Girls

U14

U10 / U12

Goalies






 Sign Up!

Parent's First Name: 

Parent's Last Name: 

 

Enter the name of the player in the fields below.
 

Player's First Name: 

Player's Last Name: 

 

You must choose a user name and password that you will use to login to your account through this web site in the future. When you have logged in you can see your currently scheduled sessions as well as enroll for future sessions.
 

Login User Name: 

Login Password: 

 

Enter the following information about the player.
 

Date of Birth: 

Age Group / Level  
for 2008/2009 Season: 
 

Will this be your 1st, 2nd, 3rd,
or 4th year at this level? 
 

Position: 

 

Address: 

City: 

State: 

Zip: 

 

Please make sure you enter a valid phone number and e-mail address since we use these methods to contact you regarding your account.
 

Phone: 

Alternate Phone: 

Email: 

 

Mites, Squirts, Pee Wees, Bantams  
List your preferred weeks here: 

 

Name On Credit Card: 

Type of Credit Card: 

Credit Card Number: 

CVS Number: 

Expiration Date: 


Please type in your 
payment amount here, 
along with any notes 
or comments: 

 
 

Make sure you have filled out all of the fields on this form. Only the Alternate Phone field is not required. Once all fields are filled out, click the "Click Here to Send" button below.


I acknowledge and understand that each player is voluntarily participating in activities that involve risk of injury which might result not only from their actions, inactions, or negligence, but the actions, inactions or negligence of others, the rules of play, the conditions of the premises, or any of the equipment used. This includes any risks not reasonably foreseeable to Impact Hockey, the Minnetonka Youth Hockey Association or Pagel Activity Center.

I assume the foregoing risks as a condition of participation and accept personal responsibility for the damages following any such injury.

I unconditionally release, waive, and consent not to sue Impact Hockey, the Minnetonka Youth Hockey Association, or Pagel Activity Center or its employees for any and all liability to the undersigned.

Check this checkbox to acknowledge that you understand and agree to the above conditions.
 

 

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