30+ Men

Tournament*
- Lake Placid Full Fee- $275
- Lake Placid Deposit- $150
- Lake Placid Balance- $125
First Name*
Last Name*
Date of Birth
MM slash DD slash YYYY
Position*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Jersey Size
Short Size
Preferred Jersey Number

Please list at least 3 options
Player Email*
Phone Number*
Payment Preference
Please hit Submit to complete your order. If you have selected the Venmo option, you will be redirected to PayPal, at which time your order is complete. Please Venmo the Payment to @Joe-Mester with Placid 25 in the memo