Registration

Registration

GLENCOE MINOR HOCKEY ASSOCIATION
2010 - 2011 REGISTRATION

SURNAME:		FIRST NAME:

DATE OF BIRTH: (dd/mm/yyyy)

Address: Address: City, Prov. Postal Code	,	Phone:

E-mail

AGE DIVISION FOR UPCOMING SEASON			OMHA OWHA (Girls)

MOTHER:		FATHER:

REGISTRATION FEE: VOLUNTEER FEE: TOTAL REGISTRATION:	$525.00 $100.00 $625.00	*DEDUCT $75.00 FROM "REGISTRATION FEE" IF PAYMENT MADE BEFORE APRIL 30, 2010.

GOALIES WILL NOW BE REQUIRED TO SUBMIT A DEPOSIT OF $200.00 TO SCOTT PURBRICK (519.287.3221) FOR THE USE OF THE EQUIPMENT FOR THE SEASON. ALL EQUIPMENT MUST BE RETURNED IN GOOD SHAPE IN ORDER TO GET DEPOSIT BACK. Payment to be made to Glencoe Minor Hockey Association. One set of cheques for multiple players is acceptable. I understand that it is my responsibility to keep the GMHA advised of any changes in the above information. I am the Parent/Guardian of the above player. I hereby give my consent for the above mentioned player to play hockey under the auspices of the Glencoe Minor Hockey Association and to abide by the rules of the GMHA. I also accept financial responsibility for registration of the above player. By signing you have agreed to the parent code of conduct.

Date: (dd/mm/yyyy)		Parent/Guardian:
REGISTRATION DISCOUNT OF $75.00 WILL APPLY FOR ALL REGISTRANTS BEFORE APRIL 30, 2010.

Payment Options

Pre-Reg by Apr 30th		Re-Reg after Apr 30th		New Reg by Aug 15th
April 25,2009 June 27, 2009 Aug 15, 2009	$185.00 $185.00 $180.00 $550.00	July 31,2009 Aug 15,2009	$315.00 $310.00 $625.00	Aug 15, 2009 Sept 1, 2009	$275.00 $275.00 $550.00