Muskrat Minor Hockey Registration Form 2014-2015
Registration Form 2017-2018
HOUSE LEAGUE COMPETITIVE
PREFERENCE COBDEN BEACHBURG WESTMEATH
PLAYER FAMILY NAME
(PLEASE PRINT) / PLAYER GIVEN NAME / SEX / DATE OF BIRTH
F M / Month / Day / Year
Civic/Street Address: / City: / P.Code:
Box#, R.R. #, etc.
Mailing Address: / Email:
Township:
Goalie:
Yes No / Division:
IP Novice Atom PeeWee Bantam Midget / New to Muskrat Minor Hockey Association
Yes (Please attached birth certificate)
No
Father’s Name: / Mother’s Name:
Civic Address: / Civic Address:
City: / Postal Code: / City: / Postal Code:
Home Phone: / Work: / Home Phone: / Work Phone:
Cell Phone: / Cell Phone:
PARENTS ARE EXPECTED TO HELP WITH FUNDRAISING AS REQUIRED DURING THE SEASON.
I, the undersigned certify the above information to be true and in consideration of the granting of this certificate to me with the privileges incident thereto, and by signing this certificate I have become subject to the rules, regulations and decisions of Hockey Canada, it's Board of Directors, it's Branches and/or divisions which may be restrictive in some areas such as movement from team to team, conduct, etc. and I agree to abide by such rules, regulations and decisions of Hockey Canada, it's Board of Directors, it's Branches and/or divisions. Further, the information requested above is required by Hockey Canada to facilitate hockey programs on behalf of the registrant and Hockey Canada. Hockey Canada will treat this personal information with the utmost respect and in accordance with the Hockey Canada Privacy Policy at all times.
Terms and procedures for registration are posted at the three rinks. I understand with my signature below that the player, parent(s)/guardian(s) have read, understand and accept the terms in reference to playing Muskrat Minor Hockey.
Parent/Guardian Signature: ______Date:______
Registration Fees
Division /
- Registration Fees after September 1st increase to $500.00 : applies to all returning registrations. IP registrations are exempt. NO EXCEPTIONS
- Extra Monthly Fee for Competitive payable when teams have been chosen.
- Deduct $25.00 for 3rd, 4th child
- $80.00 FEE NON-REFUNDABLE
- $50 NSF CHARGE
IP First Year (4 years old) / $300.00
IP Second Year (5 years old) / $350.00
IP Third Year (6 years old) / $375.00
Early Bird Registration:
NOVICE, ATOM, PEE WEE, BANTAM, MIDGET
Before August 15 / $440.00
Registration Fee after August 15th *See Note* / $490.00
Amount eligible to Children’s Fitness Tax Credit: $
Date Received: / Received by:
Please mail registration and payment to MMHA Box 406, Cobden, ON K0J 1K0