South River Hockey, Inc.

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2025/26 Registration

PLAYER INFORMATION

* Player First Name:

* Player Last Name:

* Street:

* City:

* State:

* Zip Code:

* Birthdate:

* Gender:

* Current High School:

* Grade:

* USA Hockey Number:

* Hockey Position:

* Experience:

Examples: [ Bowie, Navy, Tri City, NOVA, Metro, No Club ]

* Program:

* Division:

* Age Level:

The highest division played above 12U.

* Highest Division Played:

* Uniform Size:

* Returning SR Player:

Number worn during the last South River season

South River Assigned Jersey Number:

If Player email or phone number are not provided
Parent/Guardian#1 information will be used.

Player Email:

Player Phone:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* Email:

* Primary Phone:

Other Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

EMail:

Primary Phone:

Other Phone:

MEDICAL EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

* indicates required fields

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2025/26 Registration