NAME:
AGE:
GRADE:
T-Shirt Size:
NAME:
AGE:
GRADE:
T-Shirt Size:
NAME:
AGE:
GRADE:
T-Shirt Size:
NAME:
AGE:
GRADE:
T-Shirt Size:
PARENT'S NAME:
PHONE NO.:
ADDRESS:
(Very Important)
EMAIL:
I am interested in helping in the concession area:
NAME:
Other information: (Please let us know if brothers or sisters are playing or car pooling) We will make
every effort to comply with scheduling requests.
Make Check Payable to: Wings ~N~ Wheels
Mail payment to:
Wings-N-Wheels c/o Matt Berry
1217 Brooke Ave., Celina, OH 45822        
Questions: Matt Berry: 419-586-6531 (Email:
berryhome1@roadrunner.com)
The above registered player(s) have read and agree to abide by the "PLAYERS’ CODE OF EXCELLENCE"
I the parent of the above registered player(s) have read and agree to " RELEASE AND WAIVER OF LIABILITY
AND INDEMNITY AGREEMENT "
“WINGS ~N~ WHEELS”
YOUTH INLINE HOCKEY PROGRAM
“But those who hope in the Lord will renew their strength.  
They will soar on wings like eagles; they will run and not grow weary,
they will walk and not be faint.”  - Isaiah 40:31
Registration Form – Due Oct. 18, 2015
$90 fee includes camp, league and t-shirt!!    14 weeks of HOCKEY!
3 or more children playing from one family you pay only $80 per child.
Maximum cost per family is $300
Due to the growth of our league and limited rink time, please return your fees and
registration form early to ensure your child’s spot.
(Limited scholarships available based on financial need. Contact us.)
Registration Information - Camp and League Sign-Up
Child/Children Participating (as of Oct. 18, 2015)
Use this form for the Adult League also.  
T-shirt Youth Sizes: Small (size 6-8); Medium (size 10-12); Large (size 14-16)
Adult Sizes: Small 34-36; Medium 38-40; Large 42-44; XL 46-48; XXL 50; XXXL 52     
All Rights Reserved. Copyright © 2004-2014
Wings ~N~ Wheels” is a 501(c)(3) non-profit organization
A SPORTS OUTREACH MINISTRY
INLINE ROLLER HOCKEY