Hockey Registration Certificate - Free Download
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Hockey Registration Certificate
Hockey Registration Certificate
HOCKEY CANADA
2010-2011 PLAYER REGISTRATION CERTIFICATE
MALE FEMALE GOALIE IMPORT
SURNAME
GIVEN NAME
YEAR MONTH DAY
DATE OF BIRTH
RESIDENTIAL ADDRESS
CITY PROVINCE
POSTAL CODE:
FOR BRANCH USE ONLY
TELEPHONE NO.:
HOSPITALIZATION NO.
DATE APPROVED
E-MAIL
IS ELIGIBLE TO
PLAY FOR THE
(Hockey Team name in full including Association name.)
RESIDENT AT THE ABOVE ADDRESS SINCE
CITIZENSHIP: CANADA OTHER
HOCKEY CANADA BRANCH REGISTRAR
I registered last with the following Team(s) Please X if never registered before
YEAR: TEAM: in the Branch/Province
YEAR: TEAM: in the Branch/Province
I have read and agree to the terms on the back of this form with respect to use of personal information
DATE SIGNED 20 PLAYER'S SIGNATURE
This card is issued at the discretion of the Branch Executive, and is revocable without notice.
CATEGORY CARD #
PLAYER'S RELEASE
The Hockey Team herewith grants
unconditional release to player
whose signature appears on the reverse of this card
President
Secretary
SIGNATURE SIGNATURE
DATED:
I, the player who signed the other side of this form certify the information provided 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, its Board of Directors, its 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, its Board of Directors, its 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 information with the utmost respect and in accordance with the Hockey Canada Privacy Policy at all times.
Hockey Canada does not sell, trade or otherwise share the information we collect outside our Branches and Associations however
we may from time to time use this information for the purpose of offering additional services, promotions, including promotions
offered by third parties and/or hockey specific research. This type of usage or your personal information by Hockey Canada, its
Branches and/or Associations is entirely at your discretion, should you choose to allow this type of usage please check the box below
For more information on Hockey Canada's Privacy Policy please visit our web site at www.hockeycanada.ca or call (613) 562-5677
Parent or guardian must sign here for all players under the age of majority.
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