2008-2009 SHOOT OUT IN DODGE Tournament Roster Form

All teams must be registered with USA Hockey.
All teams will be required to submit a valid USA Hockey roster when they check in at the tournament.

Please send completed form to:
Dodge County Hockey Tournaments
c/o Kim Edgar
P.O. Box 321
Kasson, MN 55944
or kimberlyedgar@kmtel.com
507-634-6055

Fields marked with an asterisk (*) must be entered.

* Age group
Bantam B - January 9, 10, 11 2009
Bantam C - January 9, 10, 11 2009
PeeWee C - January 23, 24, 25 2009
Squirt C - January 23, 24, 25 2009
Squirt A - February 27, 28, March 1 2009
Squirt B - February 27, 28, March 1 2009
* Team name
* Contact person
* Address
* City
* State
* Zip code
* Phone number
* E-mail address
Team Roster
Player # Player Name Jersey # Player # Player Name Jersey #
1 11
2 12
3 13
4 14
5 15
6 16
7 17
8 18
9 19
10 20
* Head Coach * CEP# * Level * Date  Assistant 1  CEP#  Level  Date  Assistant 2  CEP#  Level  Date  Assistant 3  CEP#  Level  Date  Assistant 4  CEP#  Level  Date  Team Manager
* Team Jersey Color