2016 WINTER WOMENS ICE HOCKEY LEAGUE WEDNESDAY NIGHT APPLICATION

 

 

NAME___________________________________DATE OF BIRTH_______________

 

STREET________________________________CITY___________________________

 

STATE________ZIP____________HOME PHONE____________________________

 

CELL PHONE________________________WORK PHONE____________________

 

E-MAIL________________________________________________________________

 

                                               

                                    PLEASE INDICATE PREFERED POSITION

                                                        FORWARD_____________

                                                        DEFENSEMEN__________

                                                        GOALIE________________

                                                           

WOULD YOU CONSIDER YOURSELF A C OR D LEVEL PLAYER

C__________        D__________

( I WILL DO MY BEST TO ACCOMMODATE EVERYONE WHEN CHOOSING YOUR DIVISION. BUT I DO RESERVE THE RIGHT TO MAKE ANY NECESSARY CHANGES IN THE BEST INTEREST OF THE LEAGUE)

 THE ABOVE NAMED REGISTRANT HAS AGREED TO PAY $252.00 (BROKEN INTO 2 PAYMENTS OF $126.00) TO PARTICIPATE IN THE HOCKEYTOWN USA, INC. WOMENS ICE HOCKEY LEAGUE.

THIS FEE COVERS THE FALL SESSION OF THE 2016 HOCKEY SEASON. THE LEAGUE CONSISTS OF APPROXIMATELY 14 GAMES TO BE PLAYED ON WEDNESDAY NIGHTS FROM JANUARY 6TH 2016 TO APRIL 6TH 2016. THE GAMES WILL BE PLAYED AT 7:40PM & 8:50PM INDIVIDUALS WILL BE SELECTED AND PLACED ON TEAMS. EVERY EFFORT WILL BE MADE TO BALANCE THE TALENT LEVEL OF EACH TEAM. SHIRTS WILL BE PROVIDED BY THE LEAGUE.

MAKE CHECKS PAYABLE TO HOCKEYTOWN USA AND SIGN THE LIABLILITY WAIVER ON THE BACK OF THIS APPLICATION AND SEND TO:

 

HOCKEYTOWN USA

 953 BROADWAY

 SAUGUS, MA 01906

 

APPLICANT’S SIGNATURE______________________________DATE__________

 

FOR OFFICE USE ONLY

 

RECEIPT #___________________DATE_______________

AMOUNT PAID_____________________INITIALS_________ 

 PLEASE PRINT AND SIGN LIABILITY WAIVER HERE

 


 

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