Cranbrook Minor Hockey Association Player Registration Form 2017/2018 Season
Mail Registration to CMHA #10 1777 2nd ST N Cranbrook BC V1C 7G9
CMHA Website: www.cranbrookminorhockey.com
PLAYER INFORMATION
Last Name
First Name
Street Address
City/Town
Primary Phone
Gender
M F
Birthdate m/d/y
1ST Year Player
Y
Postal Code
New to
BC Care Card #
Town? Y
2017/2018 Division From Below
Primary Email
Rep Tryout
N
Y
Previous Team
N
**LAST REGISTRATION DAY FOR REP IS SEPTEMBER 1ST , 2017 **
DIVISION (check one)
BIRTH YEAR
EARLY BIRD
AFTER JUNE 9TH
PUPS
MITES
NOVICE
ATOM
ATOM REP**
PEEWEE HOUSE
PEEWEE REP**
BANTAM HOUSE
BANTAM REP**
MIDGET HOUSE
MIDGET REP**
2012
2011
2010/2009
2008/2007
2008/2007
2006/2005
2006/2005
2004/2003
2004/2003
2000/2001/2002
2000/2001/2002
$325
$510
$525
$525
$740
$525
$740
$525
$740
$525
$740
$375
$560
$575
$575
$790
$575
$790
$575
$790
$575
$790
DEBIT_____
CHEQUE $_____________x _________
**CHECK ONE: CASH_____
MC_____
VISA_____
TOTAL
1. Registrants may submit post-dated cheques for the 30th day of each month from June through
November. All fees must be paid in full by November 30th.
2. Rep try out fees of $90 are included in the above price schedule and are non refundable once tryouts
begin. Baseline concussion fees are also included for Pee Wee, Bantam and Midget rep.
3. Any Bantam, Midget or Female player not registered in an association last year is ½ price.
PARENT/GUARDIAN INFORMATION (please print and complete in full)
MOTHER/GUARDIAN
FATHER/GUARDIAN
Name:
Name:
Address (if different from Child)
Address (if different from child)
Email:
Cell #
Emergency Contact
Home #
Email:
Cell #
Cell #
Home #
Home #
Release: In consideration of this application to play under the auspices of CMHA, I do hereby for myself,
heirs, executors, administrators and assigns, remise, release and forever discharge Hockey Canada, BC
Hockey, EKMH and CMHA, their Officers, and anyone acting on their behalf from all manner of litigation,
damage, claims, or demands, in law of equity which I may have or aquire by reason of personal injury, loss or
damage to property, which may occur during or by reason of participation in the activities of CMHA.
Signature of Parent/Guardian_____________________________________
Date___________________________