LONDON EAST OLD-TIMERS HOCKEY LEAGUE
APPLICATION/WAIVER FOR 2017/2018 SEASON
http://www.leohockey.net/
APPLICATION
Name:
Age:
(Please print)
(as at Oct 1, 2017)
Occupation:
Address:
Postal Code:
City:
Home #
Business #
Cell #
E-mail:
Rate yourself (Circle one)
5A
5B
(All-Star +)
(All-Star)
4A
4B
3
2
(House League)
Preferred Playing Position: (Circle 1st choice; box 2nd choice)
G
LD
RD
C
LW
RW
I wish to volunteer to: ____________________________________
Voluntary Positions:
Are you planning to play next season? (Check one; write any explanations on back.)
Yes: ___
No: ___
Spare: ___
AWARDS VOTING: (Votes must be for a player on another team to ensure unbiased results.)
Best Defenseman in the league: ________________________________________
Giff Award (substantial contribution to League): __________________________
Sportsmanlike Player: _________________________________________________
Can you or your company (please) provide a banquet prize(s)?
Yes: ___
No: _______
WAIVER
By my signature below as a team and or league member or participant, I alone am responsible for my
personal loss due to accident or injury. I agree not to act against the league organizers or members when
participating in league activities, and agree to yield to all league officials and abide by the rules as a
condition of participation.
Signature: _________________________________
Birthdate: ____/____/_________
(mm/dd/yyyy)
Note: The organizers find collecting the fees the most difficult task. Please cooperate by submitting this
completed application and a cheque payable to LEO Hockey, for the season’s fee (postdated Oct. 1, 2017)
by the finals on Apr. 8, 2017 to assist organizers and to secure your position. Next season’s fee is $400.00
and the final deadline for submission is Apr. 14, 2017. (Bad cheques will cost an additional $25.00)
Mail cheques: to LEO Hockey, c/o Don Dixon, 247 Starlight Ave, London, ON N5W 4X8
Hockey should begin Oct. 01, 2017. Players wishing to join the LEOHL as full time players should submit a
completed application and a postdated cheque, and their names will be added to the waiting list. After
Sept. 1, 2017, players on the waiting list will be used to replace regular players who are delinquent with
their cheques or relinquishing their full time status.
Please fill in ALL BLANKS. Comments or suggestions are appreciated and considered - use reverse.