USPHL SUMMER SHOWCASE PLAYER REGISTRATION FORM

10 Mar 2017 by Frank Scarpaci

FLORIDA EELS REGISTRATION FOR THE USPHL SUMMER SHOWCASE
JULY 13th-16th 2017 (Birth Years:1997– 2001)
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 You Played For: __________________________________________________
Level: HS____A____AA____AAA ____ Junior______
Position: Goalie L-Defense R-Defense R-Wing L-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 costs, lodging, and meals. Please remit your payment to the address located below. Your check should be made payable to 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:____________________

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