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REGISTRATION FORM
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Email
*
Parent's Name
*
First
Last
Telephone Number
Cell Phone Number
Birth Date
*
Date Format: MM slash DD slash YYYY
Age
*
Group
*
Novice (13,12)
Atom (11,10)
Peewee (09,08)
Bantam (07,06,05)
Sex
*
Male
Female
Position
*
Goalie
Forward
Defence
T-Shirt Order
*
Application must be received by June 1st to receive a free t-shirt.
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult XS
Adult S
Adult M
Adult L
Adult XL
$350 Players
$300 Goalies
Your child will not be registered unit we have received full payment.
We accept: Cheque, Money Order and E-transfer.
Please make cheque out to Micheal Ferland Hockey School
Cheques can be mailed to Box 1803 Virden MB R0M2C0
E-transfer can be sent to
michealferlandhockey@hotmail.com
The password for E-transfer will be "hockey".
Hockey School Policy
In signing this application, the parent certifies that the child is in good, normal health and has no physical handicaps. The school will provide every safeguard for the health and wellness and welfare of each child, but will not be responsible for sickness or accidents. We reserve the right to use any pictures take during your child’s play at the school for advertising or instructional purposes. The applicant agrees that Micheal Ferland Hockey School will not be held responsible for any accidents or loss, however caused, and agrees to release the proprietors from all claims or damages which may arise as a result of or by reason of such accident or loss. I have read and agreed to the above conditions.
Signature of Parent/Guardian
*
Date
*
Date Format: MM slash DD slash YYYY
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.
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