REGISTRATION

ALASKA AFFILIATE SELECTS REGISTRATION DEC 2009

Player Evaluation Form Dec 2009 Tryouts

The Alaska State Hockey Association will be conducting tryouts for the Alaska Affiliate Select Program on December 19-21, 2009 in Anchorage at the Subway Sports Centre. The tryouts are open to any female player (US citizen) who is registered with USA Hockey for 2009-2010 and in the following birth years: 1993, 1994, 1995, 1996. The tryout fee is ($95.00) dollars. This fee includes a jersey the player will get to keep at the end of the tryout & 4 hours of ice (includes 3 hrs for tryouts and 1 hour pre-tryout ice on 12/18).

Please complete the form below and when finished click on the pay with PayPal button to pay the fee and complete your player's registration. Additionally, the forms (Code of Conduct and Consent to Treat) found on the home page of this website must be downloaded, completed, signed and mailed to Kim Rupp- address provided with forms on home page of this website.

Registrant Information

Name:


First	Last

Address:

City, State Zip:

Phone:

Email:

Parents Names:

Include In Scout Book:

Fly From - City Name:

Birth Year:

Position:

Year In School:

Player Height :

Player Weight (Enter number only eg: 125):

Player Shoots (Catches for Goalies):

Team (1) Name 2009/2010:

2009/2010 Goals (Team 1):

2009/2010 Assists (Team 1):

2009/2010 Number of Games Played (Team 1):

2009/2010 Penalty Minutes (Team 1):

2009/2010 Goalies - Save% (Team 1):

2009/2010 Goalies - GAA (Team 1):

Team (2) Name 2009/2010:

2009/2010 Goals (Team 2):

2009/2010 Assists (Team 2):

2009/2010 Number of Games Played (Team 2):

2009/2010 Penalty Minutes (Team 2):

2009/2010 Goalies - Save% (Team 2):

2009/2010 Goalies - GAA (Team 2):

Team (1) Name 2008/2009:

2008/2009 Goals (Team 1):

2008/2009 Assists (Team 1):

2008/2009 Number of Games Played (Team 1):

2008/2009 Penalty Minutes (Team 1):

2008/2009 Goalies - Save% (Team 1):

2008/2009 Goalies - GAA (Team 1):

Team (2) Name 2008/2009:

2008/2009 Goals (Team 2):

2008/2009 Assists (Team 2):

2008/2009 Number of Games Played (Team 2):

2008/2009 Penalty Minutes (Team 2):

2008/2009 Goalies - Save% (Team 2):

2008/2009 Goalies - GAA (Team 2):

Comments:

PRE-TRYOUT ICE REGISTRATION

$20.00

PRE-TRYOUT ICE FEE FOR 1997 BIRTH YEAR PLAYERS OR PLAYERS NOT REGISTERED FOR THE SELECT TRYOUTS Pre-tryout ice fee for players not participating in the select tryouts. Subway Sports Centre
December 18, 2009	7-8pm

2009 AK AFFILIATE SELECT TRYOUT REGISTRATION

$95.00

2009 AFFILIATE SELECT TRYOUT REGISTRATION Tryouts will be held at the Subway Sports Centre in Anchorage
December 19-21, 2009	Times TBA

Please remember to download, print, complete, sign and mail the Code of Conduct and Consent to Treat forms to Kim Rupp (address provided with forms). Once all forms and payment have been received your player will be registered for the tryout.