^{Euro Team:}  ---Select Team---- STOCKHOLM (2002) - Mark Roy STOCKHOLM (2001) - Jim Macdonald STOCKHOLM (2000) - Mike Slobodnik STOCKHOLM (1999/2000) - Thomas Nelson STOCKHOLM (1998) - Travis Richards STOCKHOLM (1997) - Norm Krumschmid ------------------------------ MOSCOW (2001) - Sergei Bautin MOSCOW (2000) - Paul Cavallini MOSCOW (1999) - Gino Cavallini MOSCOW (1998) - Keldon Koblick MOSCOW (1997) - Jon Rogger

^{Last Name:     First Name:    MI:}  

^{Address:      
 
City:               State/Prov:       Zip:}   

^Country:  USA Canada Other      ^Citizen:  USA Canada Other

^{Date of Birth:}    (enter with slashes   mm/dd/yyyy)

^{Home Phone:           Parent Cell#:}             

^{Parent/Guardian    First Name:    Last Name:}   

^{E-Mail Address:      
 
E-Mail Address:}      

______________________________________________________________________

^{Primary Position: Forward      Defense   Goaltender                         Shot / Catch:   Right      Left}

^{Current Team:         Current Coach:}         

^{Coaches Phone:     Coaches E-Mail Address:}     

 ^{Other Hockey References:}       

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^{Preferred Jersey Number (please pick three):}                         

^{Jersey Size:   Youth Small     Youth Medium    Youth Large
                Adult Small     Adult Medium    Adult Large      Adult X-Large     Adult 2X-Large}

^{Socks Size:   Youth      Intermediate    Adult}