2008 Summer Adult 4 on 4 Hockey League
Team Representative Form
Please print this page, fill out necessary information and send to:  
ICE Arena, 5165 E. Remus Rd., Mt. Pleasant, MI 48858
Team Representative Name:                                                                        

Address:                                                                                                

City:                                          State:                  Zip:                                

Home Phone:(        )                                                Work Phone:(        )                                            

Email:                                                        

Date of Birth:                                                

Team Name:                                                                

Protected Player List:
Team Representative may protect one skater and one goalie (plus team rep) for a total of 3 players.  
The remaining team members will be drafted through the general player pool at the rate skate.

Player 1 (Team Rep):
                                                                               

Player 2:                                                                        


Player 3 (Goalie):                                                                        

Must be a Goalie. If you don't have a goalie leave this blank.  
You cannot protect an extra skater in this place.

This form must accompany the individual player registration for the team representative.