Minor Hockey Registration Form

Player Name

Gender Female Male

Players Birthdate (mm/dd/yyyy)

What Division of Play - Hockey Learn to Play - $375 U7 - $375 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE U9 - $425 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE U11 - $600 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE U13 - $700 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE U15 - $800 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE U18 - $800 before June 15th. A LATE FEE OF $75 WILL BE APPLIED AFTER THIS DATE

Payment will be made via (Registration is not considered complete until payment is submitted). A $75 Late Fee will be added to any registration paid after June 15th EMT - submit to pvminorhockey@gmail.com Check - Deliver to Treasurer Cash - Deliver to Treasurer

Is participant going to be trying out for Elite Hockey (AA and up) Yes No

Is participant applying to play overage Yes No

Any restrictions (ie. Allergies, Disabilities)

Address

City

Postal Code

Legal Land Description

Parent or Guardian Name

Email Address (required for contact)

Phone

Parent or Guardian #2 Name

Email Address for Parent or Guardian #2

Phone for Parent or Guardian #2

In order to have successful seasons we require many helping hands on the team or at an organization level. Please indicate if there is a position you could help with Coach Assistant Coach Manager Ref Coordinator Safety Rep Team Rep

If interested in filling an additional volunteer position please indicate Coach Assistant Coach Manager Ref Coordinator Safety Rep Team Rep

Submit