TSMHA Checking Clinic Registration (Tecumseh-Shoreline Eagles)

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Print TSMHA Checking Clinic Registration

You must be registered with TSMHA in order to attend this camp.

This registration form allows us to cross check the Hockey Canada Registration for insurance purposes

This checking clinic is:

MANDATORY FOR "New To Travel" 2005 born players & coaches
MANDATORY FOR ALL 2006 born players & coaches
Optional for 2007 born players & coaches but strongly recommended and encouraged

Date: Sunday April 28th 2019
Where: Tecumseh Arena
When: 1:30PM - 4:00PM

This session included 1 hour of classroom, and 1.5 hrs on ice

I agree to the terms and conditions stated above^*

Player Information

Please fill out completely

Player Name^*
Sex^*
MaleFemale
Address^*
City^*
Postal Code^*
Home Phone^*

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

Date Of Birth^*

Open the calendar popup.

2018/19 Season Team^*
If you selected "Other Centre", please specify organization and level
Any allergies or medical information we should be aware of?

Concussions, pre-existing injuries, medications, etc

Primary Parent/Guardian Info

Name^*
Address (if different from player)
Home Phone^*

Example: ###-###-####
Cell Phone^*

Example: ###-###-####
Email Address^*

Example: [email protected]

Secondary Parent/Guardian Info

Name^*
Address (if different from player)
Home Phone^*

Example: ###-###-####
Cell Phone^*

Example: ###-###-####
Email Address^*

Example: [email protected]

Human Validation

Check The Box ^*