New Player Registration (Belle River District Minor Hockey Association)

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Print 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^*
Player Name^*
Sex^*
MaleFemaleOther

Players Birthday ^*

Open the calendar popup.

Ethnicity^*
Address^*
City/Town^*
Postal Code^*
How long has the player resided at this address?^*
Phone Number^*

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

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^*

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^*

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^*

Human Validation

Check The Box ^*