Baltimore Ice Dogs Minor Hockey Association
Player Registration Form (Part 1) for 2007-08

Child's Surname: _______________________

First Name: _________________

Date of Birth: Day __________ | Month __________ | Year __________

Address: Indicate lot and concession and 911 No. _____________________________

_______________________________________________________________________

Town or Township of : ___________________

Postal Code: ________________

Parent/Guardian (1) Name: ________________

Phone: _____________________

Parent/Guardian (2) Name: ________________

Phone: _____________________

PLEASE INDICATE PREFERRED METHOD OF COMMUNICATION:

Email Address:  _____________________        Phone:  _________________________

Parent/Guardian Information:
-In consideration of allowing the above named person to play hockey, I hereby, personally and on behalf of him or her, release the Baltimore Minor Hockey Association, the directors and agents thereof from any and every obligation, liability, claim or demand whatsoever arising out of any injuries or accidents, or the treatment thereof, including, and without limitation, liability in tort, and extending to all damages whenever and wherever arising, including but not limited to, any injuries incurred during the playing of the game, the practices and transportation to and from the arenas or any other Baltimore Minor Hockey function.

-I understand and agree that my name and phone number will be listed on my child's team list and be made available to coaches and executive members.  I also understand and agree that articles and/or photos of my child may be used in newsletters, bulletin board postings, brochures, or on this B.M.H.A. website.  

-I agree that my child will be playing by B.M.H.A. Constitution and Playing Rules.

Parent/Guardian Signature:  ______________________________________________

Dated: _________________________

Played last season: (Division) _____________________ | (Centre) ______________

Will your child be trying gout for Rep hockey?  Yes ____ | No ____

Will your child be trying out elsewhere for Rep hockey? Yes ____ | No ____

Would your daughter be interested in girl's hockey (if offered)?  Yes ____ | No ____

Please remember Player Registration Form part 2