Registration Form

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Team Information

Division:

Team:

Personal Information

First Name:

Last Name:

Address:

City:

Province:

Postal Code:

Phone:

Email:

BirthDate:

Username:

Password:

Confirm Password:

Registration Information

Did you play Fall/Winter 2009/10? No $20.00 Yes

Is this your second team registration? No Yes $20.00

Do you require a Player Card? No Yes $5.00