QRMHA - April 2024 Late Tryout (WAIVER) Registration Form (Quinte Red Devils)

QRMHA - April 2024 Late Tryout (WAIVER) Registration Form

This form is for players arriving at tryouts on a AAA waiver after the first tryout skate. Please fill out this form completely.

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. A payment of $100 through the Sports Pay App (below), using Visa or Mastercard is required to complete the registration process.

Thanks !

I agree to the terms and conditions stated above^*

1. 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")

Age Group^*

Required

(please select the age group)

AAA Centre Issuing Waiver^*

Required

(please indicate the AAA centre that has issued the waiver)

Position^*

Required

(Select a position from the list)

Shoots / Catches^*

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)

2. 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: ###-###-####

3. Payment

The Sports Pay App will appear after the form has been submitted. At that point you will be asked for your credit card information.

Please pay this amount -^*

Required

Please read and acknowledge the following important points...

1. I understand that registration is not complete until payment is made. A payment of $100 through the Sports Pay App (below), using Visa or Mastercard is required to complete the registration process.

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^*

3. I am aware that I MUST bring a copy of my AAA Waiver that I received from my Home Centre to the tryout.

4. I am also aware that I must email my AAA Waiver to the head coach and to [email protected].

I agree to the terms and conditions stated above^*

QRMHA - April 2024 Late Tryout (WAIVER) Registration Form (Quinte Red Devils)

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1. Player Information

2. Parent / Guardian Information

3. Payment

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