 |
Players Name:
_________________________________
Age: ___ /____/______
Day
Month Year
Address:
________________________________________
Age verified by: ______________
City:
_______________ Postal
Code: ____________
Address verified by: ____________
Telephone:
_____________________
Cell:
_____________________
Age level
as of December 31:
Instructional
Alt. Contact:
__________________ Phone: _______________
(2003-2004):
c
Tyke:
(2002):
c
Parent’s Email:
_______________________________________
Novice: (2000-2001):
c
Atom
(1998-1999):
c
Alt. Email:
_______________________________________
PeeWee (1996-1997):
c
Bantam
(1994-1995):
c
Previous Hockey Experience:
Midget:
(1991-1993):
c
Team/League
2007-2008: ______________________________
Juvenile
(1989-1990): c
2006-2007: ______________________________
2005-2006: ______________________________
Is player trying out for another team?
Other:
_______________________________________________
Yes c
No c
_______________________________________________
Goalie c
As
Parent/Guardian of
__________________________ I
give my permission for the registrant to play hockey in the Oshawa Church Hockey
League. I understand that the Oshawa Church Hockey League will not be held
responsible for accident or injury which may be incurred in the course of
travel, games and practices. I further understand that, in addition to this
registration fee, additional funds will be required for expenses incurred by the
team to which the registrant will be assigned.
I
hereby provide authorization to the Oshawa Church Hockey League to release the
name and address of the registrant identified on the registration form to the
City of Oshawa. This information is collected pursuant to the Municipal Freedom
of Information and Protection of Privacy Act and under the authority of the
Municipal Act for the sole purpose of verifying participation numbers and the
allocation of ice time to the community.
______________________________
______ ____________________________
Parent/Guardian Signature
Date
Witness
Cash c Cheque c Visa c
Mcard c Amex c
_______
No. ________
|
27-1300 King Street East, Box
231, Oshawa, ON, L1H 8J4
(905)721-8547
www.OCHL.org
Registration fee in the amount of $275, for
registration in the Oshawa Church Hockey League, a recreational hockey league,
$275 of which meets the eligibility
requirements for the Children’s Fitness Tax Credit, has been
received from ______________________
for the registration of ________________________
born in _____ .
Payee
Player
year
Date:
______________ Authorized
signature: ___________________________________
Official
Receipt – retain for Income Tax purposes
