U14 (2011) - Prep Skate Registration (Quinte Red Devils)

U14 (2011) - Prep Skate Registration

This form has a limit of 15 submissions. At the moment this page loaded, 10 submissions have been submitted. It is possible that not all submissions have been validated at this time, and more openings could become available. However, at this time only 5 more submissions will be accepted.

General Instructions:
1. Please fill out this form completely.
2. An email address is required to complete the form. It will be used for all further communication. Please ensure that it is typed in correctly.
3. The U14 - 2011 group will have 4 Prep Skates for a total of $160. A payment of $160 using VISA or Mastercard is required to complete the registration process. You will be directed to the Sports Pay site after you submit this registration form. Please have your credit card information ready for when you get to the payment section of this form.
4. The U13 and U14 age groups will be combined for the Prep Skates.
4. There is a limit of 30 skaters for the combined U13 & U14 Prep Skates.
5. There is no charge for goaltenders for the prep skates, but they must be registered on a separate registration page.

Thanks !

I agree to the terms and conditions stated above^*

I. Player Information

First Name^*

Required

(Enter player's First Name)

Last Name^*

Required

(Enter player's Last Name)

Date of Birth - Month / Day / Year^*

Required

(Please use the "date picker")

Position^*

Required

(Select a position from the list)

Shoots^*

LeftRight

Required

(Choose "Left" or "Right")

Home Centre^*

Required

(Enter your Home Centre)

Team Played for Last Season^*

Required

(Enter the team played for last year)

email address to be used for ALL acknowledgement and communications^*

Required

Please accurately type in your email address

Street Address^*

Required

( 123 Maple St)

City / Town^*

Required

( enter your city / town)

Postal Code^*

Required

( enter your postal code - A8M3D9)

II. Parent / Guardian Information

Parent / Guardian's Name^*

Required

Please enter parent / guardian's first and last name

Parent / Guardian's Cell #^*

Required

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

Emergency Contact Name^*

Required

Please enter the name of an emergency contact

Relationship to Player^*

Required

Cell Phone #^*

Required

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

III. Payment

Please make sure that you have your credit card information ready. You will be directed to the Sport Pay site after you "submit" this form.

Please pay this amount -^*

Required

1. I understand that registration is not complete until payment is made. (Payment of $160 via VISA or Mastercard on the Sports Pay site.)
(Goaltenders are not required to pay for the prep skates and should register on the correct registration page.)

I agree to the terms and conditions stated above^*

2. I release QRMHA from all liability due to INJURY, ACCIDENT or LOSS of PROPERTY during the tryouts and related activities.

I agree to the terms and conditions stated above^*

U14 (2011) - Prep Skate Registration (Quinte Red Devils)

OMHA Digital Network

I. Player Information

II. Parent / Guardian Information

III. Payment

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