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2013-2014 Registration Form

This document contains the 2013-2014 player registration form for the Perth Girls Hockey Association (PGHA). It requests player information such as name, address, date of birth, parent/guardian details, and previous hockey experience. Players can register to play at the Fundamental, Novice, Atom, Peewee, Bantam, Midget, or Senior levels. Registration fees vary from $275-650 depending on the level and date registered. Families registering 3 or more players receive a 15% discount on fees. All families must also participate in a $100 fundraising raffle by selling tickets.

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44 views

2013-2014 Registration Form

This document contains the 2013-2014 player registration form for the Perth Girls Hockey Association (PGHA). It requests player information such as name, address, date of birth, parent/guardian details, and previous hockey experience. Players can register to play at the Fundamental, Novice, Atom, Peewee, Bantam, Midget, or Senior levels. Registration fees vary from $275-650 depending on the level and date registered. Families registering 3 or more players receive a 15% discount on fees. All families must also participate in a $100 fundraising raffle by selling tickets.

Uploaded by

NoonTime
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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PERTH GIRLS HOCKEY ASSOCIATION 2013-2014 PLAYER REGISTRATION FORM

www.perth.goalline.ca

PLAYER INFORMATION
_________________________________________ First Name __________________________________________ Last Name

___________________________________________________________________________________________________ Street Address / RR# City or Town Province Postal Code ___________________________________________ Township __________________________________________ Date of Birth (Day, Month, Year) ___________________________________ Parent /Guardian ___________________________________________ Phone Number _____________________________________________ Email Address

_______________________________________________________ Address if different from Player

Association Last Registered With: ________________________________________ Year:_______________ *Player Release form is required if registered with a different association in the previous year. *Copy of Birth Certificate is required for all new PGHA Members . Player Position: __________________________ Interested in playing Goalie: _______ Is Player interested in trying out for a competitive Team? ____________ (Additional fees may apply)
I, the undersigned and/or co-signed 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, 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 facilitated hockey programs on behalf of the registrant and Hockey Canada and the Perth Girls Hockey Association. Hockey Canada and the Perth Girls Hockey Association will treat this personal information with the utmost respect and in accordance with the Hockey Canada Privacy Policy at all times.

Parent /Guardian Signature_____________________ Players Signature___________________________


(If player is under 18 years of age)

Consent given to use player photos on PGHA website:

yes

no

Age Level for 2013-2014 Fundamentals: 07/08/09/10 Novice 2005/2006 Atom 2003/2004 Peewee 2001/2002 Bantam 1999/2000 Midget 1996/1997/1998 Intermediate 1992/93/94/95 Senior 1991+

Deposits will be made on the 15th of each month and registrations must be paid in full by September 15th. Players that do not have their registration paid by September 15th will not be permitted on the ice. **Registrations handed in on April 21st 2013 will receive a $50.00 discount. The discount ONLY applies if full payments are handed in on that day (including post dated cheques). If you do not provide full payment then the discount does not apply.**
Families with 3 or more children registered in the PGHA will receive a 15% discount this discount only applies to registration fees and not fundraising.
Below is a list of divisions and a breakdown of their registration fees: Level/Division Registration Fee handed in on April 21st 2013 $275.00 $390.00 $390.00 $390.00 $480.00 $480.00 N/A N/A Registration Fee from April 22nd June 30th 2013 $325.00 $440.00 $440.00 $440.00 $530.00 $530.00 $650.00 $520.00 Registration Fee July 1st or after $375.00 $490.00 $490.00 $490.00 $580.00 $580.00 N/A N/A

Fundamental Novice Atom Peewee Bantam Midget Midget AA Senior

**The Town of Perth requires all players that live outside the contributing townships pay a non contributing user fee, therefore any player not residing in the Town of Perth, Tay Valley, Drummond North Elmsley, Lanark Highlands and the Town of Smiths Falls will be subject to this on top of their registration fee ** **There will be NO refunds issued after December 31st 2013**

In addition to the above registration fees, each family will be required to take part in the PGHA fundraising. The cost of fundraising will be $100/family and you will be given a book of raffle tickets. Each ticket is worth $5 and whatever tickets you sell, you keep the money. A separate cheque is required for the fundraising and MUST be paid on or before September 15th.
PGHA USE ONLY Registration Paid By: Cash Cheques If paid by cheque, payments are as follows: Cheque # __________ Dated: ___________ Cheque # __________ Dated: ___________ Cheque # __________ Dated: ___________ Cheque # __________ Dated: ___________ Cheque # __________ Dated: ___________ Cheque # __________ Dated: ___________ (fundraising) Raffle Tickets: #_____________ to # ________________ Other: ______________

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