Full Name

Affiliation

Email

Telephone

Participation Type

Coach

Official

Player

Administrator

Fan

Game Level

Youth

High School

Game Type*

Women's/Girls'

Men's/Boys'

Suggested change

Rationale

Equipment Type*

Helmet (boys)

Eye protection (girls)

Headgear (girls)

Shoulder pads/chest protection

Arm protection

Rib protection

Gloves

Goalie chest protection

Goalie throat protection

Goalie gloves

Pelvic/Groin protection

Goalie leg/Shin protection

Sticks (boys)

Sticks (girls)

Sticks (goalies)

Mouth guards

Balls

Other

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