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NAHL: Corpus Christi IceRays

CCAHA SIGN UP FORM

If you have any questions contact the IceRays front office at 361-814-7825 (Ask for Amanda)

PLEASE SIGN UP BY EITHER....

A.)  DOWNLOADING THE FORM, FILLING IT OUT, AND BRING IT TO THE ICERAYS 
       FRONT OFFICE OR FAX IT TO 361-980-0003.

B.)  FILL OUT THE ONLINE VERSION BELOW. 

2014-2015 COST: $350

Youth Hockey Registration

Enter the text above:

 

Corpus Christi Amateur Hockey Association

Player Application and Information Form

2014-2015

Please Print

Player Name: ________________________________________________________________

(Last)                                                                      (First)                                                      (Initial)

Circle One:   Male     Female                     Age _____     Date of Birth _____________________

Division: ________________

 

****CCAHA MUST HAVE A COPY OF BIRTH CERTIFICATE AND USA

HOCKEY REGISTRATION NUMBER BEFORE PLAYER IS ALLOWED ON THE ICE*****

Cost is $350.00 for the Season

***********NO REFUNDS************

 

Address: ______________________________________________________________________

City: _____________________________________________  State: _____  Zip: _____________

Home Phone: ______________ Cell Phone: _______________ Texting #            : _______________

E-mail Addresses: _______________________________________________________________

Mother’s Name: ________________________ Employer: __________ Work #: ______________

Father’s Name: _________________________ Employer: __________ Work #: ______________

Previous Ice Hockey experience?    ____ Yes    _____ No

 

 

Parents please read and sign the following statement:

The player named above has my permission to participate in the activities of the Corpus Christi Amateur Hockey Association, (hereinafter named CCAHA). I agree to pay the fees and abide by the policies established by CCAHA. I also understand that the player must be a member of USA Hockey in good standing. If I fail to do either, the player will not be allowed to participate. I release and will not hold responsible CCAHA, it’s officers, coaches, referees, other players or the Corpus Christi Ice Rays and its staff for any accidents or injuries occurring as a result of activities sponsored or directed by CCAHA. I give my permission for CCHA or its representatives to obtain emergency medical attention for my child if I am not available for consultation at the time of injury.

 

 

____________________________________________                        ______________________

Parent or Guardian Signature                                                                         Date

 

BRING THIS FORM TO THE ICERAYS FRONT OFFICE OR FAX TO 361-980-0003