Step 1: Register your Child with USA Hockey

Step2: Register your child for the
Polar Bears Learn to Play Hockey

·   Log onto www.usahockey.com

·   Click on the “Become a member” link on the right side of the screen

·   Register each player.  This provides the necessary insurance for all skaters (even learn to play hockey players)

·   You must enter your child’s name as it appears on their birth certificate.  NO NICKNAMES

·   The fee is $30 per player , payable with on-line credit card

·   Print out the USA Hockey confirmation page.  Submit the confirmation page along with payment.

Complete our on-line Registration form Below. Mail your $70 Learn to play Hockey Fee and
USA Membership confirmation to.

CT Polar Bears
C/O Beth Wood
20 Rebecca Lane
Killingworth, CT 06419

Checks Payable to: CT Polar Bears
For questions about the registration process Contact Beth Wood-Leidt at bwoodleidt@gmail.com or by phone at
413-386-8779

Learn to Play Hockey On-line Form

Skaters First Name
Skaters Last Name
Date of Birth
Parents Name
Address
City
State
Zip
USA Hockey Registration Number
Primary Email
Home Phone
Cell Phone

I, as parent of the above named player, agree, by both checking the box below and by my signature on my check remitted for the
 Learn to play Hockey fees, for myself and my daughter that the Connecticut Polar Bears Women's Hockey Club, Inc.,
 and its agents, servants, and employees, shall in no way be responsible or liable for any injury of any kind to my daughter,
arising out of or in the course of any operations of said hockey club. It is my intention to waive and release any and all claims of
any kind whatsoever, in law or in equity of my enrolled daughter, in her own right and as guardian of my daughter, a minor, on
account of any injury of any kind arising out of or in the course of any operations of said hockey club. Also, it is agreed that any
equipment which the Connecticut Polar Bears may use in conducting the tryouts is not guaranteed or warranted in any fashion. This is a general release of all claims. This release is given in consideration of my daughter being allowed to participate in a
 Connecticut Polar Bears skating program.

I indicate my consent to the above by checking the following box:
 I accept the above terms