2009 Summer Novice/Shinney Registration

To register please provide the information below:

(Note - You must have a USA Hockey Registration # for the 2008-09 season to continue.)
To register go to: http://www.usahockeyregistration.com/

Player Information
  
         
Date of Birth:    / /
Street Address:  
         Position:          Sex:  
PARENTAL AUTHORIZATION
I, the parent or guardian of the above candidate for the WBHA hockey program, hereby give my approval to his/her participation in any and all activities of this program during the current season. I assume all risks and hazards incidental to such participation, including transportation to and from such activities and do hereby waive, release, absolve, indemnify and agree to hold harmless the WBHA, the organizers, supervisors, sponsors, participants and persons transporting my child to and from activities, for any claim arising out of an accident or injury to my child, except to the extent and in the event covered by accident and/or liability insurance held by the WBHA. I also understand the fee to register my child is to be non-refundable.
Upon request, I agree to return any uniform(s) or other equipment issued to my child in as good condition as when received, normal wear and tear excepted. I agree not to permit the use of the uniform or other equipment in any activity not sponsored by the WBHA. I will furnish a copy of the birth certificate for the above child when and if such certificate is requested by the officials of the WBHA.
By signing this statement, I agree to be a member of the Wheatfield Blades Hockey Association (WBHA) and understand that I may not be able to play for another team unless I get a release. TheWheatfield Blades will issue releases in March and April to all players who have met their obligations to the WBHA and/or team.
  I agree to the above terms and conditions
Parent/Guardian Information
   Last Name :      First Name: 
Email Address:
I also state that: (Check one of the boxes) I played for WBHA last year                                                I played outside of Western New York or didn't play
I have a release from my prior team, which is presented now Other Situation (explain)

If "Other Situation" explain:

Please check box for Program you wish to register for Novice     Shinney (Ages 8 and Under)      Shinney (Ages 9 and 10)      Shinney (Ages 11 and 12)
Mailing Address: Wheatfield Blades Hockey Association, 3385 Niagara Falls Boulevard, North Tonawanda, NY 14120