PMHA Player Registration
After filling the details click on the SUBMIT button.
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indicates required fields
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Players Name:
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D.O.B (mth/day/yr):
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Street Address/box #:
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Town/City:
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Province:
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Postal Code:
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Parent(s)/Gardian(s):
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Home Number:
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Work Number:
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Cell Number:
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Email Address:
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Level Registering For:
Initiation
Novice
Atom
Peewee
Bantam
Midget
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Position:
Foward
Defense
Goalie
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Last Two TeamsPlayed For:
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Two Emergency Contacts:
This is a quick registration form, other information may be needed at time of payment of $160.00. You may register and pay in person at the Giant Tiger in the Porcupine Mall on Sept 9,10 2010 from 6-9pm. We play for the fun of it.
Copyright© 2007 Porcupine Minor Hockey
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