Individual Sign Up Sheet
Please fill out completely and print using the print selection on your computer.
Individual player fee: $100.00

Please select this button and fill out the
waiver at the bottom and send along with your fee.
If you are under 18, you must have a guardian or parent sign this waiver.
Please print this page by using the "Print" control under the "File" menu and send along with a check to:
RDJ Hockey, llc, 2233 Hamline Avenue N, Suite 127, Roseville, Minnesota 55113

When you have completed this form, please push the Submit button at the bottom of the  page.

Name

Address

City State Zip  

Phone (H)  (C)  

E-Mail

School or Association

Level or Age Team or Area Name

Coach or Organizers Name

Coaches Phone: (H)   (C)  

Coaches E-Mail
Please send a check to the address above, thank you!