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Chicago Mission Youth Hockey Club
 

SPRING REGISTRATION FORM

 
                                            Lookup Your Number Here
 ***MUST HAVE TO CONTINUE** 
 
                                       
Last Name: First MI
Address
City State Zip
Date of Birth (enter with slashes mm/dd/yyyy)           Male    Female
Cell Phone E-Mail
 
Parent / Guardian First Name(s) Last
Parent Cell Phone Parent E-Mail
Parent Cell Phone Parent E-Mail
 
Primary Position   Forward      Defense     Goaltender                  Shot/Catch   Right      Left
Last Season Team Coach
 


 

 

 
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