AOTHANewPlayerRegistration
AllnewplayersrequestingtoparticipateintheAdrianOverThirtyHockeyAssociation(AOTHA)
mustfirstapplytobecomeamemberofAOTHA.UponBoardreview,verificationofyourAOTHA
NewPlayerRegistrationandplayervacancy,theannualregistrationfeeof$50isrequired.This
feesecuresyourstatusandholdsyourpositionintheAOTHAleague.
Thisformhasfillablefields.Fillout,printandbringitwithyoutotherateskate.
ALLINFORMATIONBELOWMUSTBECOMPLETELYFILLEDIN
WhatPosition(s)areyouInterestedinplaying,checkallthatapply?
!Forward!Defense!Goalie
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First&LastName
DateofBirth
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FullAddress(Street,City,ST,Zip)
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MobilePhone#
Email
MEDICALINFORMATION:Doyouhaveanyphysicalormedicalconditionsrequiringspecialconsiderations?
IFYES…PLEASEEXPLAINONBACKOFTHISAGREEMENT.
!YES !NO
IherebysubmitmyregistrationtoparticipateintheAdrianOverThirtyHockeyAssociation(AOTHA).IagreedthatIwillpay
allfeesinaccordancewiththefeepaymentscheduleoutlinedbyAOTHA.Ifurtheragreethatifsuchfeesarenotpaidperthe
feespaymentschedule,IcannolongerparticipateinAOTHAuntilmymembershipaccountispaidinfull.IfurtheragreethatI
willfurnishmyownrequiredequipment.Themandatoryhockeysafetyequipmentwhichmustbewornislistedinfulldetail
onlineunderthe‘AOTHABylawsandRules’onAOTHA’sofficialwebsiteataotha.com/about/documents.
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Signature:
Today’sDate
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PlayerinformationverifiedviaDriversLicense/StateID?YESNO
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