3ON3 REGISTRATION | Breakawayperformance

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REGISTRATION

(Parents / Player Information)

Parents Full Name

City

Contact Number

Email

Street Address

Postal Code

Alternate Number

Email (other)

Players Full Name

Date of Birth

Female / Male

AGE

Association Played for in 2023-24 Season

What Level Do You Play Currently

LL

REP

A

AA

AAA

DIVISION (2023/24 Season)

U9

U11

U13

U15

U18/21

Registering As a

Individual Player Entry

Team Entry

Goalie

Jersey Size (Youth)

XL (42"-44")

Large (40"-42")

Medium (38-40")

Small (36"-38")

Jersy Size (Adult)

XXXL (57"- 59")

XXL (55"- 57")

XL (53"- 55")

Large (49"- 51")

Medium (45"- 47")

Small (41"- 43")

Sock Sizes

Youth 21"

Youth 23"

Intermediate 25"

Intermediate 28"

Adult 30"

Adult XL Wide 30"

TEAM NAME IF ENTRING AS PART OF A TEAM

TEAM PAYMENT

TEAMS ARE REQUIRED TO HAVE HALF UP FRONT WHEN REGISTERED AND REMAINING FEE PAID BY MARCH 31st

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

Yes

No

Do you have any questions or comments?

* Players will be playing in the same division that they played in during the 2023-24 winter season

* Spots will ONLY be confirmed once payment has been completed

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

$380
PER PLAYER

$4,560
PER TEAM

Team payment $2250 up front, remainder due March 31st

© Breakaway Performance Hockey Skills & Development •

breakawayperformancehockey@gmail.com • Wasaga Beach, ON

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