2016-2017 > 2016-2017 Tournament > Registration (Amherstburg Minor Hockey Association)

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November 4-6, 2016
MIDGET REGISTRATION FORM

^T^EA^M^N^A^M^E
^C^I^T^Y
LEAGUE/ASSOCIATION
^T^EA^M^C^O^N^T^A^C^T^N^A^M^E
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^CO^A^C^H^(if^dⁱ^f^fe^r^eⁿ^t^f^r^o^m^ab^o^ve)
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^SW^E^A^T^ER COLOUR	^H^OME
	^AWAY
^SP^E^C^IAL^R^E^Q^U^E^S^TS^:^WE^WILL TRY TO HONOUR BUT CANNOT GUARANTEE
^M^a^k^e^$¹²⁵⁰^.⁰⁰^c^h^e^qu^e^p^a^y^a^b^le^t^o^: AMHERSTBURG MINOR HOCKEY ASSOCIATION C/O Chris Bozin 149 Park Lane Circle Amherstburg On N9V4B3

WAIVER:

I, (Team Manager) on behalf of my team, consent to participation in the Amherstburg Minor Hockey Association (AMHA) Tournament and assume all risks that

are accidental to such participation. I therefore agree to waive, indemnify and hold harmless AMHA and its representatives, employees, agents, servants and assigns. I certify that all players are in good physical and mental health and any exceptions have been noted by me with this application. I warrant that all of the players on my team have been given permission by their parent or legal guardian to participate in this tournament and that I am authorized to make this statement on their behalf. The Applicant acknowledges and agrees that AMHA reserves the sole and exclusive right to use any photographs or video taken during the tournament for advertising or instructional purposes contained herein. I acknowledge reading this Application and Declaration and understand the conditions herein and agree to abide by all terms.

Coach/Manager Signature Date Association Rep Signature

November 4-6 2016

BANTAM TEAM
REGISTRATION FORM

^T^EA^M^N^A^M^E
^C^I^T^Y
LEAGUE/ASSOCIATION


^T^EA^M^C^O^N^T^A^C^T^N^A^M^E
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^CO^A^C^H^(if^dⁱ^f^fe^r^eⁿ^t^f^r^o^m^ab^o^ve)
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^SW^E^A^T^ER COLOUR	^H^OME
	^AWAY
^SP^E^C^IAL^R^E^Q^U^E^S^TS^:^WE^WILL TRY TO HONOUR BUT CANNOT GUARANTEE
^M^a^k^e^$¹¹⁵⁰^.⁰⁰^c^h^e^qu^e^p^a^y^a^b^le^t^o^: AMHERSTBURG MINOR HOCKEY ASSOCIATION C/O Chris Bozin 149 Park Lane Circle Amherstburg, ON N9V 4B3

WAIVER:

I, (Team Manager) on behalf of my team, consent to participation in the Amherstburg Minor Hockey Association (AMHA) Tournament and assume all risks that

Coach/Manager Signature Date Association Rep Signature

November 4-6 2016

ATOM & PEEWEE TEAM
REGISTRATION FORM

^T^EA^M^N^A^M^E
^C^I^T^Y
LEAGUE/ASSOCIATION


^T^EA^M^C^O^N^T^A^C^T^N^A^M^E
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^CO^A^C^H^(if^dⁱ^f^fe^r^eⁿ^t^f^r^o^m^ab^o^ve)
^E^MAIL
^C^E^LL^P^H^O^N^E
^H^OME^P^H^O^N^E
^ADDR^E^SS
^C^I^T^Y
^POS^T^AL^C^ODE
^SW^E^A^T^ER COLOUR	^H^OME
	^AWAY
^SP^E^C^IAL^R^E^Q^U^E^S^TS^:^WE^WILL TRY TO HONOUR BUT CANNOT GUARANTEE
^M^a^k^e^$¹¹⁰⁰^.⁰⁰^c^h^e^qu^e^p^a^y^a^b^le^t^o^: AMHERSTBURG MINOR HOCKEY ASSOCIATION C/O Chris Bozin 149 Park Lane Circle Amherstburg, ON N9V 4B3

WAIVER:

I, (Team Manager) on behalf of my team, consent to participation in the Amherstburg Minor Hockey Association (AMHA) Tournament and assume all risks that

Coach/Manager Signature Date Association Rep Signature

Registration, 2016-2017 Tournament, 2016-2017 (Amherstburg Minor Hockey Association)

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