Girls Try Hockey Free Application

Player Name: _______________________

D.O.B._____________________________

­­­­­­_____Wednesday, August 12, 2009

7:30-8:30 p.m. Ages 13-17

_____Thursday, August 13, 2009

5:45-6:45 pm Ages 8-12

Please check all above that apply.

Address: __________________________

City: ___________ZIP______________

Day Phone: ________________________

Evening Phone: _____________________

E-mail Address: ___________________________________

Shoe Size:_____  Height:_______ Wt:____

By signing this application, I understand that there are hazards to skating and hockey.  I release ELLGHA, USA Hockey, I.C.E, and all staff and volunteers of any liability resulting from injury in participation.

Date:_________________

PLEASE MAIL APPLICTION TO: E.L.L.G.H.A

P.O. Box 8381   Erie, Pa. 16505

www.erieladylions.com

Deadline: August 5, 2009