WHA Online Hockey Registration

Player's First Name:
Player's Last Name:
Street Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Date of Birth:
Select program:
Timbits (Instructional) (Birthdate 2005 and earlier) $75.00 + $5.00 Convenience fee
Mini-Mite B (Birthdate 1/1/2002 thru 12/31/2004) $90.00 + $5.00 Convenience fee
Mite B (Birthdate 1/1/2000 thru 12/31/2001) $90.00 + $5.00 Convenience fee
Squirt B (Birthdate 1/1/1998 thru 12/31/1999) $90.00 + $5.00 Convenience fee
Pee Wee B (Birthdate 1/1/1996 thru 12/31/1997) $90.00 + $5.00 Convenience fee
Bantam B (Birthdate 1/1/1994 thru 12/31/1995) $90.00 + $5.00 Convenience fee
Midget B (Birthdate 1/1/1992 thru 12/31/1993) $90.00 + $5.00 Convenience fee
Midget BB (Birthdate 1/1/1990 thru 12/31/1990) $90.00 + $5.00 Convenience fee
Squirt A (Birthdate 1/1/19990 thru 12/31/1999) $90.00 + $5.00 Convenience fee
PeeWee A (Birthdate 1/1/1997 thru 12/31/1997) $90.00 + $5.00 Convenience fee
PeeWee AA (Birthdate 1/1/1996 thru 12/31/1996) $90.00 + $5.00 Convenience fee
Returning player?