By checking this box, I confirm that the person filling out this registration is at least 18 years old and is the legal parent/guardian of the child listed below. *

Yes

Participating Child's Name *

First Name

Last Name

Child's Date of Birth *

MM

DD

YYYY

Does your Child Need Hockey Equipment? *

Yes

No

Parent / Legal Guardian Name *

First Name

Last Name

Parent / Legal Guardian Cell Phone Number *

(###)

###

####

By checking this box, I give my consent for photographs and/or video to be taken of my Child at events affiliated with SCORE Boston Hockey. These images may be published in social/print media or in any manner/media as determined by NHL Enterprises, L.P., Boston Professional Hockey Association, Inc., the National Hockey League and SCORE Hockey, Inc, *

Yes