2015-16 Tryout Registration Form (Sarnia Hockey)

2015-16 Tryout Registration Form

Please fill in the information required, complete the required acknowledgements and the human validation window and when completed, click on submit. Please bring to your first tryout a copy of your birth certificate and Permission to Skate form if you are an NRP player. NRP Players cannot skate without this form. Once you close this form you will not be returned to the Sarnia Hockey website but you will receive a copy of the registration form you just submitted within about 60 minutes to the email address(s) you supplied. Payment for Tryouts must be paid by Paypal or credit card - Tryout Sarnia players $40.00 or NRP $60.00.

Player's Name^*

Date of Birth^*

example: Jan 1, 1998

If born in 2004 or later please provide Respect in Sport Registration Number

Respect In Sport Registration Number is provided upon completion of Respect in Sport Module

Select the division the player is trying out for:^*

Address:^*

Town/City:^*

Postal Code:^*

Municipality:^*

(taxes paid to)

Home Phone:^*

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

Email Address:^*

Example: [email protected]

Player's length of residence at this address: ^*

(insert year)

Lives with:^*

Both
Father
Mother

Father's Name:^*

Father's Cell:^*

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

Father's Email:^*

Example: [email protected]

Mother's Name:^*

Mother's Cell:^*

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

Mother's Email^*

Example: [email protected]

Allergies/Medical Conditions:^*

(need to be aware of)

Local Hockey Centre:^*

Position Played:^*

Shoots/Catches:^*

LeftRight

Previous Year team: 2014 - 2015^*

Previous Year Team: 2013 - 2014^*

Off Season Experience/Training:

(if any)

ACCEPTANCE OF RISK/WAIVER OF RESPONSIBILITY

I am aware and approve of the above-named player's registration to participate in tryouts for the Sarnia Hockey Association. I undertake that the above-named player is in good health except as noted above. I relinquish to the player's coach/instructor the right to instruct and direct the player during the specific team tryouts the player is participating in. The undersigned Parent/Guardian hereby releases, remises and forever discharges the Sarnia Hockey Association and their heirs, executive, coaches, trainers, managers, committees and instructors of all action, causes of actions, damage claims and demands whatsoever which may arise from any incident to the praticipating child and/or player and /or property while practicing, playing, travelling to or from hockey related events arranged by, through or supervised by though or supervised by said association.

I agree or disagree to the terms and conditions stated above:^*

AgreeDisagree

Check Only One Option

Parent/Guardian:^*

(please print name)

Date:^*

(month/day/year)

Email address:^*

Example: [email protected]. Your submission will be sent to this address.

Tryout Fee^*

click $40.00 fee for Sarnia Players, $60.00 fee for NRP

2015-16 Tryout Registration Form (Sarnia Hockey)

ALLIANCE HOCKEY Digital Network

ACCEPTANCE OF RISK/WAIVER OF RESPONSIBILITY

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