Toyota Junior Starter Sweepstakes

Parent / Guardian Information

• * First Name:
• * Last Name:
• * Date of Birth:
  (Why do we ask?) Month: January February March April May June July August September October November December Day: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year: 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916
• * Address:
• * City:
• State: Alabama Alaska Alberta Arizona Arkansas British Columbia California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nevada Nebraska New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland North Carolina North Dakota Northwest Territories Nova Scotia Ohio Oklahoma Ontario Oregon Palau Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon
• * Zip Code:
• * Phone:
• * Email:
• Yes, please register me to receive email announcements from the Hershey Bears.

Participant Information

• * First Name:
• * Last Name:
• * Youth Hockey Team: Blazers Bucks County Thunder Capital City Vipers Central Penn Panthers Chester County Cougars Delaware Ducks Delaware Rough Riders Delaware Stars Delco Phantoms Dyna-Mites Ed Snider Hockey Generals Glaciers Grundy Senators Grundy Grizzies Hatfield Ice Hawks Haverford Hawks Ice Dogs Jr. Blue Hens Jr. Knights Kings Lancaster Firebirds Lehigh Valley Phantoms Youth Lehigh Valley Rebels Old York Road Raiders Palmyra Black Knights Philadelphia Revolution Pond Penguins Quakers Valley Forge Colonials Warwick Wildcats Wilkes-Barre Jr. Pens Hershey Jr. Bears Wissahickon York Ice Hockey Other
• If 'Other', Team Name
• * Age: 6 7 8 9 10 11 12

• Please select the games in which you are interested in participating:

  * First Choice: Second Choice: Third Choice:
• Please read - Official Sweepstake Rules and Assumption of Risk and Release.
• I have read, understand, accept, and agree to be bound by the Official Sweepstakes Rules.
• I have read the Assumption of Risk and Release, understand its terms, and if I win the Sweepstakes, I voluntarily and knowingly agree to its terms individually and on behalf of my minor child participating in the National Anthem activity on the ice-rink.
• Enter Sweepstakes