Official Team Name (HCR or USA) *

Team Nickname (optional)

Team ID (if unknown enter TBD) *

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 # *