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2024 MHR Summer Jump Registration
This form is to register your child for the Manchester Hockey Roos Summer Jump program. It will help us with planning the curriculum around the number of attendees and their experience level.
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* Indicates required question
Participant's Last Name
*
Your answer
Participant's First Name
*
Your answer
Grade of Athlete in Fall of 2023
*
Choose
4th
5th
6th
7th
8th
School Attending
*
Choose
Bakersville
Beech St
Gossler Park
Green Acres
Highland-Goffe's Falls
Hillside
Jewett
McDonough
McLaughlin
Northwest
Parker-Varney
Parkside
Smyth Rd,
Southside
Webster
Weston
Wilson
Previous Experience
*
Beginner
Some Hockey Roos
Some Clinics like Summit, Cavegirl or Seacoast
I play for my Middle School
I play for a club program
Required
I need a loaner stick
*
Yes, I need a stick
No, I have one.
I need to borrow shin guards.
*
Yes, please bring shin guards for me
No thanks, I have shin guards.
Emergency Contact Info
Please provide contact info, just in case.
Emergency Contact, Last Name
*
Your answer
Emergency Contact, First Name
*
Your answer
Emergency Contact, Phone Number
*
Your answer
Emergency Contact, Email.
*
Your answer
Please follow instructions below to fill in and submit waiver.
This is the <
Waiver
>. Please download, fill in, scan or photograph, and send back to info@manchesterhockeyroos.org
If you would like to be added to our email distribution list, follow directions below.
Follow this link to a form to get on our email list for updates and programs. <
Sign up Here
>
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