Player Name:_________________________________

 

Address:_____________________________________

 

City:______________State:________Zip

                                                                 DOB:______________ Phone:________________

 

Please circle House or Travel and the division your player will skate in for the 2006/2007 season:

 

 

 PEE WEE:        BANTAM:        MIDGET         

 

 

Most recent hockey experience:(circle one)   Novice   House   Travel

 

Date Played________Division__________Where_____________

 

Mothers Last Name:_______________First Name_______________

 

Fathers Last Name:_______________First Name:_______________

 

Include with this form a Non-Refundable* registration fee payable to RTHA and a copy of the players birth certificate. Registration fee is $125.00. Please note players name on the info line of the check. Mail form to address above or drop in mailbox #1 in the RTHA mailbox  in the northeast corner of the rink behind the snack bar.

 

*registration fee refundable if RTHA is unable to place player on team