PLAYER REGISTRATION | Breakawayperformance

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PLAYER
REGISTRATION

PLAYER / PARENTS
INFORMATION

U9 FULL (waiting list started)

U11 FULL (waiting list started)

U13 FULL (waiting list started)

U15 (open spots)

U18/21 (open spots)

U13 GIRLS (open spots)

U15 GIRLS (open spots)

Players Full Name

Female / Male

AGE

Association Played for in 2024-25 Season

Date of Birth

Have You Played In Our Summer 3on3 Program Before? *

Yes

No

PLAYER REGISTERING AS A *

PLAYER

GOALIE

What Level Do You Play Currently *

LL

REP

A

AA

AAA

DIVISION (2024/25 Season) *

U9

U11

U13

U15

U18/21

Jersey Size (Youth)

XL (42"-44")

Large (40"-42")

Medium (38-40")

Small (36"-38")

GOALIE CUT

Jersy Size (Adult)

XXXL (57"- 59")

XXL (55"- 57")

XL (53"- 55")

Large (49"- 51")

Medium (45"- 47")

Small (41"- 43")

GOALIE CUT

Parents Full Name

Parents Full Name (OTHER)

Street Address

City

Postal Code

Contact Number

Email

Email (other)

Do you have any questions or comments?

* Players will be playing in the same division that they played in during the 2024-25 winter season

* Spots will ONLY be confirmed once payment has been completed

$380
PER PLAYER

* Payment can be made via EMAIL To:
tonyturner77@hotmail.com

© Breakaway Performance Hockey Skills & Development •

breakawayperformancehockey@gmail.com • Wasaga Beach, ON

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