Player's Name
:
Date of Birth
:
Age
:
2007-2008 Association/Team
:
Are you a member of USA Hockey
:
Yes
No
Position
:
Player
Goalie
Age Group
:
Peewee '96 / '97
Bantam '94 / '95
Midget Minor
Midget Major
Mother's Name
:
Father's Name
:
Guardian's Name
:
Address
:
City
:
State
:
Zip
:
Home
:
Work
:
Mobile
:
Email
:
Mini-Camp Fees:
Player Fee: $300
Goalie Fee: $150
Midget Player Fee: $150
Midget Goalie Fee: $75
Payment Information:
Credit Card
:
Master Card
VISA
American Express
Name on Card
:
Card Number
:
Expiration Date
:
Security Code
:
3 digit (4 for American Express) number on back of card
Check
:
Make payable to:
AHANT
(must mail with this form)
Required fields
You may submit this form electronically (click the Submit Button),
or print and mail the completed printed form (required for check payments) to:
Dallas Stars Selects
Mini-Camp Registration
C/O Todd Plott
3417 Ashington Lane
Plano Texas 75023
