Official Team Name ("As noted on your official roster as issued by Hockey Canada or Hockey USA") *

Team Nickname (optional)

League *

Home Association Name *

Association Mailing Address Street # *

City *

Province/State *

Postal Code/Zip Code *

Country *

Head Coach First Name *

Head Coach Last Name *

Head Coach Email *

Head Coach Phone # *

Team Manager First Name *

Team Manager Last Name *

Team Manager Email *

Team Manager Phone # *

Permission # * (optional)(Required for PCAHA teams only)

Team or Association Social Platforms: (optional)

Facebook Handle (optional)

IG Handle (optional)

Twitter Handle (optional)