Regency Ice Cats Registration Form

Date of Birth:

PLAYER INFORMATION

Shoots (required): —Please choose an option—LeftRight

Primary Position* ForwardDefenseGoalie

What level did the player play in 2023 – 24: —Please choose an option—In-houseBAAAAAA

Player’s parent and/or legal guardian:

Home Address: , —Please choose an option—PAMDDE

Additional Contact:

Today's date:

* Required