First Name:   Last Name:
Home Street Address: 
City:  ,   State:    Zip: 
Home Phone:   
Work Phone: 
E-mail Address: 

Date of Birth:    

USFHA Membership # (if you don't have please get ASAP online at http://www.usfieldhockey.com/usfha/membership.htm)
Expiration Date: 

Positions Played: 
 

Uniform Shirts

Choose one and complete the information:

If yes enter the shirt number you have:  

I need to purchase uniform shirts:   Yes No   Enter size requested (these are women's shirts)  small medium large extra large

Enter 3 choices for shirt numbers (remember others have shirts from previous years so not all numbers will be available):  

Please remember there will be a $40.00 charge for the uniform shirts which you will get to keep after the tournament for use in future years.

We enter the team(s) in the Open Division of the tournament.  If you need  information about the open division please contact Stacie Gado.

If you need a hotel room please contact the housing JBS Destinations Solutions Global Housing Bureau 

College Players - Please fill out this section also so we can contact you if needed: 

School Street Address:
School Address 2 :  
City:  ,   State:    Zip: 
Phone:

School:

IMPORTANT: Please click on the submit button and  print out and send the returned the page, along with your check to Stacie at the address on the page.   Thanks.