Lasting Legacy Field Hockey National Festival Tryouts Pre-Registration

Name*
USAFH Membership #

USAFH Membership is required for insurance purposes. If you are not already a member please go to http://www.teamusa.org/USA-Field-Hockey
Date Of Birth*
Age Group?*
- U14 (Year of Birth 2001 & 2002)
- U16 (Year of Birth 1999 & 2000)
- U19 (Year of Birth 1996, 1997 & 1998)
Position*
- Field Player
- Goalie
Address Line 1
Address Line 2
City
Parent Name*
Email*
Home Phone*
Cell Phone*
Emergency Contacts
Please enter here the name and phone number of who you wish us to contact in case of an emergency
Medical
Please enter any medical condition or information of the player that we need to be aware of.
Phone
This field is for validation purposes and should be left unchanged.