2019 Girls World Goalie Summit Registration Step 1 of 5 20% Player DataFirst Name*Player Last*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Player PhonePlayer Email* Enter Email Confirm Email Please double-check email addresses, as all communication from CHS regarding this event will be via email.Player TwitterPlayer InstagramHow Did You Find Us? Hockey InformationDate Of Birth* MM DD YYYY Enter Player's Date Of BirthGraduation Year*Please enter a value between 1996 and 2030.Enter Player's Expected High School Graduation YearPosition*ForwardDefenseGoalieShot*LeftRightN/AHeight (FT'In)*Weight (Lbs.)*Other Sports PlayedCurrent Hockey Team*Coach's Name*Coach's Email* Coach's PhoneAlternate TeamAlt. Coach NameAlt. Coach Email Alt. Coach Phone Academic InformationSchool Name:*GPASATACTAre You Registered With NCAA Clearinghouse?YesNo Parent InformationParent 1 First Name*Parent 1 Last Name*Parent 1 Email* Enter Email Confirm Email Please double-check email addresses, as all communication from CHS regarding this event will be via email.Parent 1 Phone*Parent 2 First NameParent 2 Last NameParent 2 Email Enter Email Confirm Email Please double-check email addresses, as all communication from CHS regarding this event will be via email.Parent 2 Phone Waiver/ReleaseI, the parent / guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of College Hockey Showcases, LLC, and it’s affiliated organizations and sponsors. Recognizing the possibility of physical injury, associated with ice hockey and in consideration for the College Hockey Showcases, LLC accepting the registrant for its ice hockey programs and activities, I hereby release, discharge and/or otherwise indemnify College Hockey Showcases, LLC all Board members, coaches, its affiliates, organizations and sponsors, their employees and associated personnel, including the owners of the facilities used for the programs, against any claims by or on behalf of the registrants as a result of the registrant’s participation in the programs and/or transportation to or from the same, which transportation I hereby authorize. All information will be kept confidential, and I authorize that it be provided to NCAA coaches/scouts upon their request.Refund/Cancelation PolicyPlayer registration cancellations must be received in writing via email to email@example.com For player registration cancellations received less than 90 days before the start of the showcase, CHS will retain a $100 administrative fee. No refunds will be issued for player registration cancellations within 60 days of the start of the event. Player registration cancellations due to injuries or illness, with a valid letter from your physician will be handled on case-by-case basis. If College Hockey Showcases, LLC. or its event partner cancels an event, all registrants will receive a full refund of fees paid (no administrative fee) no later than 30 days following the scheduled date of the event. All refunds will only be made using the original form of payment. For example, if you registered using a Visa card, any refund will be credited back to that same Visa card. Registrants are responsible for carefully reviewing all event related registration information. College Hockey Showcases, LLC is not liable for any expenses incurred for travel or accommodations if an event is cancelled. I Agree To The Terms & Conditions Listed Above* I Agree This iframe contains the logic required to handle AJAX powered Gravity Forms.