HOCKEY REGISTRATION 2019-20

OUTLOOK MINOR SPORTS

2019-20 Hockey Registration

OPEN MAY 1 - 31, 2019

Athlete Information

Player Name *

First Name Middle Name Last Name

Birthdate *

Sask. Health Card Number *

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent 1

First Name Last Name

Parent 2

First Name Last Name

Rural Land Location

Home Phone *

Area Code Phone Number

Parent 1 Cell Phone *

Area Code Phone Number

Parent 2 Cell Phone

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

Emergency Contact

Emergency Contact's Name *

First Name Last Name

Relationship *

Phone Number *

Area Code Phone Number

I have read and agree to the above conditions *

Yes No

OMS MEDICAL FORM