Camp Registration | Blue Chip Selects Registration

Select a Division *

Player First Name *

Player Last Name *

Player Birthdate *

Position *

Age Group *

Current Team *

Parent First Name *

Parent Last Name *

Parent Email *

Parent Phone *

Address *

City *

State / Province *

Zip / Postal Code *

Emergency Contact Name *

Emergency Contact Phone *

Waiver *

I certify that the above named applicant is fully covered by a health insurance plan or USA Hockey and Blue Chip Hockey LLC, and its Staff are not responsible or liable for any injury suffered by the aplicant during participation at Blue Chip Select events. Blue Chip Select LLC, reserves the right to accept only the players or teams they conclude meet the standards established by the coaching personnel.

Payment

Total - $ 0.00

Online payment

Other payment methods

Credit Card Holder Name *

Credit Card Number *

Expiration Date *

CVV Code *

Please send your check within 7 business days to PO Box 37 Manville RI 02838. Please note your child’s name & birth year. Spots may not be held if payment is not received within 7 business days.