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Player Registration Form

ALL REGISTRANTS MUST PRINT THE SUBMITTED VERSION AND MAIL FORM AND PAYMENT IN TO THE BELOW ADDRESS.

Mail cheques to:    The South Shore Mustangs
                              P.O. Box 444
                              Bridgewater, Nova Scotia  
                              B4V 2X6

* Indicates required field.

First Name *

  Last Name *

Date of Birth *
Month
 Day
 Year

Email Address *


Confirm Email Address *


Street Address


City


Province/State


Postal/Zip Code


Phone Number


Secondary Phone Number


Height
ft.   inches.

Weight
lbs.

Position *


Last Team Played For *



Parent Information

First Name

  Last Name

Email Address *


Confirm Email Address *


Phone Number



Payment Information
Spring Identification Camp
3 Day ID Camp April 7th to 9th$125.00 CAD 

WAIVER

I acknowledge that participation in sport activities involves the risk of personal injury.  In consideration of participating in this hockey clinic, I accept that risk regardless of the nature of the injury.  I agree and understand that the South Shore Major Midget Hockey Club, its officers, employees, agents and representatives shall not be liable for any personal injury, death, loss of property or damage as a result of my participation in sports activities at the hockey clinic, whether caused directly or indirectly by the fault or negligence of the South Shore Major Midget Hockey Club, its officers, employees, agents or representatives or otherwise.  I hereby release, indemnify and hold harmless the South Shore Major Midget Hockey Club, its officers, employees, agents or representatives of and from all claims, causes of action, costs, expenses or demands which myself, my heirs, executors, administrators or assigns may have with respect to any such injury, death, loss or damage.  By signing below, I confirm that I have read, understood and accept the above conditions.
 
Click here to agree to the above Waiver Form.



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