2017 SUMMER HOCKEY LEAGUE
PLAYER’S NAME:
___________________________________________________
FULL ADDRESS: ____________________________________________
____________________________________________
DATE OF BIRTH: _________________________________
AGE: ____________________________
PARENTS NAMES: _______________________________
_____________________________
GENDER:
FEMALE
MALE
HOME PHONE: ______________________
WORK PHONE: __________________________
CELL PHONE: _______________________
EMAIL: _________________________________
CATEGORY (check box):
ATOM (2007 and 2008 born)
BANTAM (2003 and 2004 born)
PLAYING POSITION (circle one): FORWARD
NOVICE (2009 and 2010 born)
PEEWEE (2005 and 2006 born)
MIDGET (2000 to 2002 born)
DEFENCE
GOAL
Office use only
Payment Type:
Cheque: __________________
Cash:_____________________
Credit:____________________
Debit:____________________