Registration - , - Phone: Email:



Player Profile

General
Address
Required Fields:
First Name:
Last Name:
Date Of Birth:
Height:
Weight:
First Line:
Second Line:
City:
State:
Zip:
Guardian Info
Personal Contact
Parent/Guardian 1
First Name:
Last Name:
Phone:
Parent/Guardian 2
First Name:
Last Name:
Phone:
Email:
Home Phone:
Cell Phone:
Academic
Current Team Information
High School:
Year of Graduation:
ACT Score:
SAT Score:
Grade Point Average:
Current Team:
Coaches Name:
Coaches Phone:
Coaches Email:
Previous Teams:
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Current Season Hockey Information
Accomplishments
USA Selects:
Shoots:
Games Played:
Position:

Assist:
Goals:
Save %:
GAA:
PIM:
List highlites (accademic, personal, other sports, and hockey)
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Parental Approval
We agree that this information can be provided to the scouts or representatives of college, junior and professional teams

Medical Release
If in the event my child is injured during the absence of parent or legal guardian, I give my permission for the person in charge to seek medical attention.

Release of Liability / Acknowledgement of Risk
I/we agree to abide by the conditions of Midwest Xposure. I/we understand and appreciate that participation or observation of Midwest Xposure Hockey Tournament is done at my/our own risk and agree to hold harmless Midwest Xposure Hockey Tournament, Upper Midwest High School Elite League, Shattuck St. Mary’s School, all employees, instructors, volunteers and sponsors for any claim whatsoever.


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