New Player Registration (Belle River District Minor Hockey Association)

New Player Registration

Please ensure you email a copy of the players birth certificate upon completion of this form to [email protected]

Player Information

Citizenship^*

Required

Player Name^*

Required

Sex^*

Male
Female
Other

Required

Players Birthday ^*

Required

Ethnicity^*

Required

Address^*

Required

City/Town^*

Required

Postal Code^*

Required

How long has the player resided at this address?^*

Required

Phone Number^*

Required

Example: ###-###-####

Has player played for any other center? If so which one?

Reason for submitting form^*

New Player
Transfer to BRDMHA - Travel Player
Transfer to BRDMHA - House League Player

Required

Parents Information

Fathers Name

Fathers Address

(if Different then players)

Fathers City/Town

(if Different then players)

Fathers Postal Code

(if Different then players)

Fathers Phone Number

(if Different then players)

Fathers Email Address^*

Required

Example: [email protected]

Mothers Name

Mothers Address

(If different from player)

Mothers City/Town

(If different from player)

Mothers Postal Code

(If different from player)

Mothers Phone Number

Example: ###-###-####

Mothers Email Address^*

Required

Example: [email protected]

Special Request

Full new Player registation will not occur until the Registration Director receives:

1) Copy of Players Birth Certificate
2) Parent Respect in Sport Program has been completed.

Questions maybe directed to the BRDMHA Registration Director ([email protected])

I agree to the terms and conditions stated above^*

New Player Registration (Belle River District Minor Hockey Association)

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Player Information

Parents Information

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