FLORIDA EELS 2017 REGISTRATION FORM FOR THE PRO AM NHL PREDRAFT SHOWCASE: MAY 12th – 14th, 2017
Name:_____________________________ Cell Phone:____________________________
Parent/Guardian Name:_______________________ Cell Phone:______________________
Address:_________________________________________________________________
City:_____________________________________ State:________ Zip Code:___________
Date of Birth:__________ Graduation Year:______ School Attending:___________________
Player Email:__________________________ Parent Email:_________________________
Last Team Played For _______________________________________________________
Level: HS___A___A A ___AA A ___Juniors____
Position: Goalie L-Defense R-Defense Right Wing Left Wing Center
Height:________________ Weight:______________ Shot:________ Glove:____________
Statistics: Goals:_______ Assists:_________ Penalty Minutes:_________ GAA:___________
The cost of the tournament is $275.00. All players are responsible for their own transportation, lodging, and meals.Please remit your payment to the address listed below. All checks should be made payable to the FLORIDA EELS.
Frank Scarpaci
2250 Broadway
Fort myers, Florida 33901
If you wish to pay the tournament fee by credit card, please provide the following information:
Name as it appears on card:_________________________________________________________
Billing Address:___________________________________________________________________
City:______________________State:________________ Zip Code:__________________
Credit Card No.:____________________________________ Exp. Date______________
3 digit code on back of card:____________________