Junior Player Application - USARS NATIONAL INLINE HOCKEY

2025 Global Inline Challenge Application

Name

Date of Birth

Month/Day/Year

Address

Street Address

City

Country

Signatures

By my signature below, I agree to abide by the rules of USARS National Inline Hockey Organization, USARS (USA Roller Sports) and the United States Olympic Committee (USOPC). I understand that, if selected, I will be representing the USA while attending the Global Inline Challenege, and acknowledge the inherent risk involved with participation.

Player's Signature

Full Name

Sign

Date

Player Bio

Phone number, name and e-mail of coaches you have played for: (Mandatory-2 Coaches)

Playing History

History of playing experience in roller or ice hockey, including any prior world teams, USARS
and AAU Inline hockey events and any college team participation, listed in order of importance.

Other Experience

If Under 18 please complete the section below.

Mother's Name

Parent Phone

Parent Email

Parent Signature

Application Fee

Price$25.00

Please click return to merchant after paying to finish submitting your application.

Please note: Please enter player name and Team in the "Merchant Notes" when checking out on PayPal.

The $25 application fee will be applied to the total cost if selected.

Payment

Discount

Subtotal

Tax

Total USD