NAME date of birth HOME CLUB POSITION

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Send registration and roster information to

Viroqua Area Hockey Association - C/O Pam Soltau P.O. Box 55 Viroqua, Wi. 54665. Call or e-mail with questions;

psoltau@mwt.net, or 608-637-8661(Arena) and 608-629-5755(home)

Registration fees:

$55.00/per player,

Make check payable to Viroqua Area Hockey Association(or VAHA)