Registration Registration Form 1Registration 2Waiver3Payment Highlight Your LEAGUE(Required) Gorsebrook 2023 Summer Ball Hockey Highlight your AGE GROUP::(Required) U8 (2015, 2016, 2017) U10 (2013, 2014) U12 (2011, 2012) U14 (2009, 2010) Player Name(Required) First Name Last Name Player birth date:(Required) DD slash MM slash YYYY Player gender:(Required)MaleFemaleOtherPlayer street address Street Address Player city AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Parent /Guardian Contact info (Primary Contact):Parent Information(Required) First Name Last Name Email:(Required) Phone:(Required)Parent/Guardian contact info: (Secondary contact if neededSecondary contact if you would like us to keep two parents informed First Name Last Name Email PhonePlayer Position:(Required) Runner Goaltender Has player played in one of our leagues before:(Required) Halifax Minor Ball Hockey League Sackville Minor Ball Hockey League East Hants Minor Ball Hockey League Estimate the player current level of play (your best estimate) :(Required) 1. Beginner 2. Improving 3. Average 4. Very Good 5. Advanced Top level of ice hockey that the player has played?(Required) Never played House B/A AA AAA How did you hear about the 2023 Summer Program: We do not require volunteers for this program Not required WAIVER: In consideration of the Nova Scotia Minor Ball Hockey League (NSMBHL) permitting the player to participate in any of the activities of the Nova Scotia Minor Ball Hockey league, I, for myself, my family, heirs, successors, and executors hereby indemnify and hold harmless the NSMBHL, its directors, officers, organizers, successors, and assigns, from all costs, claims, actions, damages, or liabilities, whatever their nature or however caused, resulting from the participation of the player in any activities of the Nova Scotia Minor Ball Hockey League for the 2023 season. It is understood that player pictures may appear on the NSMBHL website or may be used to promote league activities. All players and parents understand that their picture may appear on line on in print material. If a player wishes their picture to be removed from the website or not used in future promotional materials the league will abide by all requests.9088 v'.c[;/ Player name: Player First Name Player Last Name Consent verification.(Required) I am the player, and I am over the age of majority. This player is under the age of majority, and I am their legal parent/Guardian. Parent/Guardian Name: Parent/Guardian First Name Parent/Guardian Last Name Terms & conditions(Required) By checking this box, you indicate agreement with this waiver.(Required) Select a league:(Required) Gorsebrook 2023 Summer Hall Hockey $129 + $4=$133 Registration fee: Price: $ 0.00 CAD (Your credit card will be charged () plus a service fee of 2.2% +.30 for processing)Credit Card(Required)Card Details Cardholder Name Δ
