Fort Wayne Registration 2022, Fort Wayne Regional, Mid-Am Region, American Regionals (International Silver Stick)

Print Fort Wayne Registration 2022
  1. This registration form will submit your team information for acceptance to the Silver Stick Fort Wayne Regional. You will be contacted via email once you are accepted and placed in one of the divisions. 
    Please provide accurate information to avoid errors and reassignment/cancellation of division placement.
Team Information
  1. Please Select Division your team is requesting for the Fort Wayne Regional
  2. "PSM Fort Wayne Force U14 " etc...
  3. Select one please
  4. Please provide detailed team information (Home league placement, past team placement, etc). Justify your requested division placement for the Fort Wayne Regional.
Payment Method
Please indicate your team method of payment. Registration Approval
  1. Choose payment method
Contact Information
Please enter contact information for your team. This is how we will communicate information with your team.
  1. This will be the Main contact for all correspondence.
  2. Example: [email protected] Your submission will be sent to this address.
  3. Mobile number preferred
  4. Example: ###-###-#### x###
  5. Mobile Number Preferred
  1. Pay to the Order of: FWYH - Silver Stick

    Payment must be mailed to:
    Fort Wayne Amateur Hockey Association
    SilverStick Regional
    8136 Mystic Drive
    Fort Wayne, IN 46835

    Squirt U10- $1125
    PeeWee U12- $1175
    Bantam U14- $1225

    If you chose Credit/Debit, an invoice will be created and sent to the manger email provided. A non-refundable service charge will be added to the registration fee.
Human Validation