HOCKEY REGISTRATION 2019-20

OUTLOOK MINOR SPORTS

2019-20 Hockey Registration

OPEN MAY 1 - 31, 2019

Athlete Information

Player Name*

First NameMiddle NameLast Name

Birthdate*

Sask. Health Card Number*

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Parent 1

First NameLast Name

Parent 2

First NameLast Name

Rural Land Location

Home Phone*

Area CodePhone Number

Parent 1 Cell Phone*

Area CodePhone Number

Parent 2 Cell Phone

Area CodePhone Number

E-mail*

example@example.com

DIVISION CATEGORIES

Initation (2015, 2014, 2013) First Year Initiation - $ 250.00 Second Year Initiation - $500.00 Third Year Initiation - $ 500.00Girls Initiation (2015, 2014, 2013) First Year Initiation - $ 250.00 Second Year Initiation - $500.00 Third Year Initiation - $ 500.00Novice (2011, 2012) $500Novice Girls (2011, 2012)Atom (2009, 2010) $500PeeWee (2008, 2007) $500Bantam (2006, 2005) $500Midget (2004-2002) $500

Emergency Contact

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

I have read and agree to the above conditions*

YesNo

OMS MEDICAL FORM