TSMHA Checking Clinic Registration (Tecumseh-Shoreline Eagles)

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^*

Required

Sex^*

MaleFemale

Required

Address^*

Required

City^*

Required

Postal Code^*

Required

Home Phone^*

Required

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

Date Of Birth^*

Required

2018/19 Season Team^*

Required

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^*

Required

Address (if different from player)

Home Phone^*

Required

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

Cell Phone^*

Required

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

Email Address^*

Required

Example: [email protected]

Secondary Parent/Guardian Info

Name^*

Required

Address (if different from player)

Home Phone^*

Required

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

Cell Phone^*

Required

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

Email Address^*

Required

Example: [email protected]

TSMHA Checking Clinic Registration (Tecumseh-Shoreline Eagles)

OMHA Digital Network

Player Information

Primary Parent/Guardian Info

Secondary Parent/Guardian Info

Get Mobile!

Contact Us