U8MD/U9MD Registration (Quinte West Minor Hockey Association)

U8MD/U9MD Registration

Player Section

Player's First Name^*

Required

Player's Last Name^*

Required

Player's Home Address^*

Required

Home Phone Number^*

Required

Example: ###-###-####

Date of Birth (month/day/year)^*

Required

Gender^*

FemaleMale

Required

Health Concerns^*

Required

Player's Home Centre^*

Required

Parent/Guardian Information

Information for one parent must be provided

Parent/Guardian^*

Required

Parent/Guardian Email^*

Required

Example: you@yourdomain.com. Your submission will be sent to this address.

Parent/Guardian Phone^*

Required

Example: ###-###-####

Mobile Phone

Example: ###-###-####

Parent/Guardian

Parent/Guardian Email

Example: you@yourdomain.com

Parent/Guardian Phone

Example: ###-###-####

Team Information

Team trying out for^*

Required

Preferred Position^*

Goalie
Forward
Defence

Check All That Apply

Shoots^*

LeftRight

Required

Team Last Played For^*

Required

U8MD/U9MD Registration (Quinte West Minor Hockey Association)

Player Section

Parent/Guardian Information

Team Information

Office Use Only

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