IceDome Team Registration

Team Name

Captain First Name

Captain Last Name

Date Of Birth

Phone #

Email

Street Address

City

State

Zip

Goalie Name

Player 1 Name

Player 2 Name

Player 3 Name

Player 4 Name

Player 5 Name

Player 6 Name

Player 7 Name

Player 8 Name

Captains are responsible for submitting payment prior to one week before the event and all player's USAH registration upon arrival at event. Event images will be posted online. Your personal information will not be shared.