763-717-3232
herb.brooks.league@gmail.com
HERB BROOKS LEAGUE
NORTH REGISTRATION
PARENT/PLAYER INFORMATION
First Name
Last Name
Email
Parent 1 Cell Phone
Player First Name
Player Last Name
Player Cell Phone
Birthday
Grad Year
Height
Weight
Position (2)
Select...
Forward
Defenseman
Goalie
Shot
2016/2017 Team/Association
Terms & Conditions
BILLING INFORMATION
Billing Address
Billing Address 2
Billing City
Billing State
Billing State...
Alabama
Alaska
Arizona
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California
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(AU) Australian Capital Territory
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(AU) Queensland
(AU) Northern Territory
(AU) Western Australia
(AU) South Australia
(AU) Tasmania
(ZA) Gauteng
(ZA) Western Cape
(ZA) Eastern Cape
(ZA) KwaZulu Natal
(ZA) North West
(ZA) Northern Cape
(ZA) Mpumalanga
(ZA) Free State
My State is not listed
Billing Country
Billing Country...
United States
Canada
United Kingdom
Afghanistan
Åland
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American Samoa
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Antarctica
Antigua and Barbuda
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Australia
Austria
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Canada
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Christmas Island
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Colombia
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Cuba
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Denmark
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East Timor
Ecuador
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Equatorial Guinea
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Faroe Islands
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Gabon
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Namibia
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Norway
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Panama
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Peru
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Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Réunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
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Saint Vincent and the Grenadines
Samoa
San Marino
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Senegal
Serbia
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Singapore
Sint Maarten
Slovakia (Slovak Republic)
Slovenia
Solomon Islands
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South Africa
South Georgia and the South Sandwich Islands
South Korea
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Spain
Sri Lanka
Sudan
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Swaziland
Sweden
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Syria
São Tomé and Príncipe
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
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Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
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Ukraine
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Uruguay
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Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
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Billing Zip
PAYMENT INFORMATION
Card Number
CVC
Exp. Month
Exp. Month
01 - January
02 - February
03 - March
04 - April
05 - May
06 - June
07 - July
08 - August
09 - September
10 - October
11 - November
12 - December
Exp. Year
Exp. Year
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
PRODUCT INFORMATION
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