Registration Form
Player's First Name: Last Name:
Street Address:
City: Zip Code:
Birth Date(dd/mm/yyyy): Gender: Female Male
Grade: Select an option Pre-School 1st 2nd 3rd 4th 5th
Closest Schools: Select an option AJ Katzenmaier Greenbay Howard a Yeager Marjorie P Hart North Elementary South Elementary
Forward Midfield
Defense Goalkeeper
Uniform Size: Select an option Youth Small Youth Medium Youth Large Small Medium Large Extra-Large
I, the parent or guardian of the minor registrant, agree that the registrant and I will abide by all the rules of the Mighty Ducks Hockey League (MDHL). In recognizing the possibility of physical injury associated with hockey and in consideration for the "League" accepting the registrant for its hockey programs and activities, I hereby release, discharge, and/or otherwise indemnify MDHL, their employees and associated personnel and volunteers, including the facilities used for practices and games, against any claim by or on behalf of the registrant as a result of the registrant's participation in the programand/orbeing transported to or from MDHL sponsored activities, which transportation.
By signing below, I herebyagree andauthorizethe above. In addition, by signing below, lalso acknowledge that I have read the cancellation policy and agree to its terms.
Parent/Guardian Signature:
Date:
