Thank you for signing up for Summer Hockey!

Please complete your details below and print out or save the payment instructions at the end of the registration form.

Enjoy your hockey!

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* 1. Surname

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* 2. First name

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* 3. Gender

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* 4. Birthdate

Birthdate

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* 5. I wish to play:

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* 6. Email address

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* 7. Address

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* 8. Phone

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* 9. Emergency contact details

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* 10. Any relevant medical issues/allergies

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* 11. Previous 2018 Winter Hockey Participation

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* 12. Keep me informed via e-mail about other Local Association & GBHC Events

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