2016-2017 > 4 on 4 Spring Hockey League > 2017 4on4 Registration Form (Woolwich Minor Hockey)

2017 4on4 Registration Form, 4 on 4 Spring Hockey League, 2016-2017 (Woolwich Minor Hockey)

2017 4on4 Registration Form

Completing this form is the first step in registration for Spring 4on4 hockey. You must follow this registration information with payment and payment must be confirmed by WMHA for a complete registration. An online payment option is offered after you click the Submit Form button.

Player Information

Please complete the player information requested in this section.

Player First Name^*

Required

Player Last Name^*

Required

Player Birth Date^*

Required

Use drop down or format of mm/dd/yyyy.

Level Currently Playing^*

Required

Choose One

Name of Last Team Played On^*

Required

i.e. Major Atom A

Teammate Request

One request only please - MUST be reciprocated by the other registrant

Parent/Guardian Information

Complete all fields.

Registering Parent/Guardian Full Name^*

Required

First and Last Name

Registering Parent/Guardian Phone Number^*

Required

Enter a contact telephone number

Registering Parents/Guardian Email Address?^*

Required

Example: [email protected]

Emergency Contact #^*

Required

Enter a number where you can be reached in the event of an on-ice emergency

Full Mailing Address^*

Required

Enter your full mailing address, including postal code

Payment

There are two payment options: to pay online, submit the form, and the complete payment using Paypal (you do not need a Paypal account to use your credit card to pay). Alternatively, you can personally deliver a cheque to the Hockey Office BUT the cheque must be received before registration caps at the target number of registrants. Registration is confirmed only when payment is received and confirmed by WMHA.

Are you registering a player or goalie? (NOTE: Goalie registration is closed for all divisions)^*

Required

The registration cost differs for players vs. goalies

I give approval for my son/daughter to participate in all activities and events of the WMHA 4on4 spring hockey league. I do waive, release, and absolve any accidents to such participation. I do waive, release, absolve, indemnify and agree to hold harmless Woolwich Minor Hockey Association. I certify that my son/daughter is in good physical and mental health and able to participate in the physical activity of this league. I acknowledge that I have read and understand the conditions of this application and agree to the conditions.

I acknowledge that WMHA reserves the right to cap registration at the target numbers at any time, which may occur prior to the expected registration close date.

I agree to the terms and conditions stated above^*

2017 4on4 Registration Form, 4 on 4 Spring Hockey League, 2016-2017 (Woolwich Minor Hockey)

Player Information

Parent/Guardian Information

Payment

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