Digit Murphy Hockey School at Brown University

RI IXpress Tryout Registration

Complete the form below and click on the "Submit Form" button to send your information to Digit Murphy Hockey School.

All fields are required ...

Player Name

 

Address

 

City, State, Zip

 

Parent E-Mail

 

Phone

 

D.O.B.

 

Age

 

Entering Grade
(Fall 2008)

 

Current Hockey Program (1)

 

How Many Years?

 

Position

 

Coach's Phone

 

Coach's E-Mail
Please note that not providing your coach's e-mail address will delay your request.

 

Current Hockey Program (2)

 

How Many Years?

 

Position

 

Coach's Phone

 

Coach's E-Mail
Please note that not providing your coach's e-mail address will delay your request.

 

Parent/Guardian

 

By submitting this form, I certify that I am the Parent/Guardian of the above-named applicant.

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282 Wayland Avenue, Providence, RI 02906 • Tel 401-339-1219 • Fax 401-383-1133