NELSON MINOR HOCKEY
FIRST TIME PLAYER REGISTRATION FORM 2017/2018
PO BOX 766, NELSON, BC V1L5R4
PLAYER INFORMATION
Last Name:
First Name:
Initial:
Street Address:
City:
Postal Code:
Phone:
Email:
Gender:
BC Care Card:
DOB (M/D/Y):
Applying for Kids Sport:  Yes  No
REGISTRATION FEE
$100.00
AGE
BIRTH YEAR
DIVISION
Any Division
Any
FIRST TIME PLAYER
NO CASH PLEASE
REGISTRATION NOTES:
1.
2.
3.
4.
5.
First time players are players that have not been registered in a minor hockey association.
First time players must submit a copy of their birth certificate at the time of registration.
First time players are not required to submit a fundraising deposit.
Registration can be mailed to the address above, or left at the front desk at the NDCC in an envelope labeled NMHA
Financial support available via KIDSPORT, application deadline Aug 1, 2017. For details go to
http://kidsportcanada.ca.
Parent 1/Guardian
Parent 2/Guardian
Name:
Name:
Address (if different from player)
Address (if different from player)
Home #:
Home #:
Cell #:
E-mail:
Cell #:
E-mail:
Emergency contact if parent not available
Name:
Relationship to player:
Cell #:
Home #:
OFFICE USE ONLY
DATE RECEIVED:
REGISTRATION CHEQUE # _______________
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NELSON MINOR HOCKEY
FIRST TIME PLAYER REGISTRATION FORM 2017/2018
PO BOX 766, NELSON, BC V1L5R4
Signature & Waiver:
We hereby acknowledge the authority of Hockey Canada, BC Hockey and NMHA, and agree to carry out and abide by the
constitution, bylaws, rules and regulations of those associations.
Equipment:
We, at the end of the season covered by this registration, agree to return all equipment (including jersey) provided by the
Nelson Minor Hockey Association in good condition. Should we fail to do so, we agree to pay the cost to replace the equipment
or jersey.
Release: In consideration of this application to play under the auspices of the NMHA, I do hereby for myself, heirs, executors,
administrators, and assigns, remise, release and forever discharge Hockey Canada, BC Hockey, and the NMHA, its officers, or
anyone acting on their behalf from all manner of litigation, damage claims, or demands in law or equity which I may have or
acquire by reason of personal injury to the player, loss or damage to the property, which may occur during or by reason of
participation in the activities of the association.
Privacy Clause:
NMHA does not sell, trade, or otherwise share the information we collect outside our association. However, we may from time
to time use this information for the purpose of offering additional services and promotions, including promotions offered by
third parties (ie. hockey schools). This type of usage of your personal information by NMHA is entirely at your discretion.
Media Release:
I agree to allow NMHA to use my child's team photo for use on the NMHA website or for other public relations purposes directly
relating to NMHA.
Signature of Parent/ Guardian:
Date:
Player’s Division:
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