College Point Roller Hockey

2023 Spring Registration

Child's Name *

First

Last

Child's Date of Birth *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Current School *

Jersey Size *

Do you play ice hockey?

If YES, where do you play ice hockey?

Parent or Guardian Name *

First

Last

Parent or Guardian Phone Number *

Comment or Message

If you would like to be a sponsor please email at rollerhockeycp@gmail.com for more information