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Registration Form

Your Name (required)

Your Email (required)

Phone Number (required)

Shoot L Or R (required)

Height (required)

Weight (required)

Date Of Birth (required)

Position (required)

Home Address

Medical Conditions Or Injuries (required)

Last Team Registered (required)

Last League Registered (required)

GM Name

GM Email

GM Phone

Last Grade Completed (required)

SAT Or ACT Score

Fathers Name (required)

Mothers Name (required)

Mothers Email

Father's Email

Mother's phone number (required)

Father's phone number (required)

How Did You Hear About The Express (required)

What Do You Want To Achieve By Playing Junior Hockey (required)

Why Should We Take You Over Other Players

Message to Coachs and Scouts

Would you like to attend our spring camp in North Bay Sat April 13th? (required)

Would you be interested in playing in a Spring/Summer tournament for the Express this off season? (required)