Pin Number Request Form

Please follow the instructions to complete the form below to request your Pin Number.
(Please note: If you were assigned a Pin Number last year, your request WILL be ignored. Therefore, DO NOT submit another request. Use the Pin Reminder feature to have your Pin emailed to you.)

  1. Enter all data for Primary Parent/Guardian. This is the data that is used to track all volunteer hours and it is used for online registration. The email address associated with the Primary Parent/Guardian is used for all email correspondence. Finally, the last name associated with the Primary Parent/Guardian is used as the Log In for both the Volunteers feature and the Online Registration feature. The Primary Parent/Guardian MUST live in District 284.
  2. Enter all data for the Secondary Parent/Guardian. This is optional.
  3. Enter all Player 1 data. This is required. This must be the olderst player in your family. Select the Team for your oldest player. If you are not yet assigned to a team, please leave that selection.
  4. Enter additional Players as required. Leave blank if there are no additional players.
  5. Click on the Request Pin Number button.

Please note that all information is required. Incomplete forms will not be processed. You will receive your Pin Number back via reply email within 48 hours.

This data is used for the Volunteers and Registration feature of this website. Please be certain that all data is accurate.

Primary Parent/Guardian Data
Primary Parent/Guardian Name:  Last: First:  
Primary Family Email:   
Primary Address:   
Primary City, State, Zip  ,  
Primary Phone:  - -
   
Secondary Parent/Guardian Data
Secondary Parent/Guardian Name :  Last: First:  
Address (if different from above):   
City, State, Zip (if different from above) ,  
Phone (if different from above):  - -
Email (if different from above):   
   
Player 1 (Oldest Player)  
Player 1 Team Level:
Player 1:  Last: First:  
Player 1 Birthdate & Age:  Birthdate: Age:  
Player 1 Gender:   
Player 1 School & Grade:  School: Grade:  
Player 1 Skater/Goalie:   
Player 1 Attending High School Tryout:   
   
Player 2 (Second Oldest Player)
Player 2:  Last: First:  
Player 2 Birthdate & Age:  Birthdate: Age:  
Player 2 Gender:   
Player 2 School & Grade:  School: Grade:  
Player 2 Skater/Goalie:   
Player 2 Attending High School Tryout:   
   
Player 3 (Third Oldest Player)
Player 3:  Last: First:  
Player 3 Birthdate & Age:  Birthdate: Age:  
Player 3 Gender:   
Player 3 School & Grade:  School: Grade:  
Player 3 Skater/Goalie:   
Player 3 Attending High School Tryout:   
   
Player 4 (Fourth Oldest Player)
Player 4:  Last: First:  
Player 4 Birthdate & Age:  Birthdate: Age:  
Player 4 Gender:   
Player 4 School & Grade:  School: Grade:  
Player 4 Skater/Goalie:   
Player 4 Attending High School Tryout:   
   
Player 5 (Fifth Oldest Player)
Player 5:  Last: First:  
Player 5 Birthdate & Age:  Birthdate: Age:  
Player 5 Gender:   
Player 5 School & Grade:  School: Grade:  
Player 5 Skater/Goalie:   
Player 5 Attending High School Tryout: