Players will receive their own team and personal webpage along with email support to help engage their fans and friends.

Players will receive a complimentary jersey and other promotional items.

Please note that team placement is subject to availability. We will do our best to place you on your team of choice.

Personal Information
First Name: *
Last Name: *
Address: *
City: *
State: *
Zip Code: *
Country: *
Phone Number: *
Additional Phone Number:
Email Address: *
Date of Birth: *
What industry do you work in? *
Pure Hockey Account Number:
Business Address: *
Business City: *
Business State: *
Business Zip: *
Sizing Information
At a later date, you may have the ability to reconfirm sizing for some items.
Jersey Size: *
Jersey Number: *
Jersey Display Name: *
Helmet Size: *
Hoodie Size: *
Glove Size: *
Jacket Size: *
Tshirt Size: *
Sweatpants Size: *
Shorts Size: *
Hockey Shorts Size: *
Baseball Cap Size: *
Woman Jacket Size: *
Skate Size: *
Shoe Size: *
Shipping Information
Same as Registration Information
Emergency Contact Information
Emergency Contact: *
Emergency Phone: *
Fundraising Commitment

Account Information
Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)
Sign in with Google or choose a password. You will need it to view / edit your personal web page, and see who has sponsored you for this event.
Sign in with Google
Password: *
Re-Type Password: *
Payment Details
A $100 non-refundable registration fee applies to all players.
You will be charged a $100 non-refundable fee (registration fee does not count towards fundraising goals).
Card Type: *
Card Number: *
Exp. Month: *
Exp. Year: *
Security Code: *
Additional Information optional
Additional Comments:
How Did You Hear About Us?
Waiver and Release

I accept the above waiver and release

Only enter this field if you were told to do so by a staff member.