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New Player Registration Form
Minnesota Wild Deaf/Hard of Hearing Hockey - For new players only.
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* Indicates required question
Email
*
Your email
First name
*
Your answer
Middle name
Your answer
Last name
*
Your answer
Address
*
Your answer
Address 2
Your answer
City
*
Your answer
State
*
Your answer
Zip code
*
Your answer
Country
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Citizen
*
Yes
No
Gender
*
Male
Female
Prefer not to say
Other:
Required
Phone number
*
Your answer
Have you ever been convicted or charged with a criminal offense other than minor traffic violations?
*
Yes
No
Jacket size
*
Choose
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Jersey sizes
*
Choose
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Three (3) possible jersey numbers
*
Your answer
Level of Hearing Loss
*
Choose
Less than 40dB hearing loss
Great than 40dB hearing loss
Never tested/Unknown
Contact first name
*
Your answer
Contact last name
*
Your answer
Contact phone number
*
Your answer
Comments
Your answer
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