SUDBURY MINOR HOCKEY ASSOCIATION      
  1127 Bancroft Drive            
  2nd Floor, Minnow Lake Place   Phone: 705-560-3817
  Sudbury Ontario, P3B 1R6   Fax: 705-560-9206
  Email: smha@smha.net   www.smha.net
                 
PLEASE NOTE:                
 - All Special requests will be taken into consideration, but all decisions on draft day are final  
 - All teams Atom - Midget usually charge a team fee, these are in addition to any SMHA registration fees
 - Birth Certificate is required for all first time registrants        
        Today's Date:_______________________________
                 
      PLAYER REGISTRATION FORM    
Players Name       Date of Birth YYYY - MM - DD
                   
                   
Players Address       Division Applying for       
                   
          Initiation 2005-2006   Peewee 1999-2000
City    

Postal Code

 Tyke 2004 Bantam 1997-1998
          Novice 2003-2004   Minor Midget 1996
          Atom 2001-2002   Major Midget 1994-1996
Phone Number (home) Work Phone (mother) Category      
                   
          AAA AA   Houseleague
Email     Work Phone (father) Team / Association played for last year
                   
                   
Mother (and address and phone number if different): Father (and address and phone number if different):
                   
                   
**HOUSELEAGUE PLAYERS ONLY**   Special Requests:      
Will you be trying out or playing High School Hockey? Y  or  N        
                   
Have you changed addresses since last season?  Y  or   N        
If so, you will need to fill out a residential transfer form        
                   
Are you interested in coaching or managing a team in our association? If so, provide details
                   
                   
PAYMENT INFORMATION   FOR OFFICE USE ONLY  
                   
Division __________________________ Rate______________________ Multi___________________
                   
Date Type Receipt # Post Dates Balance Owing Notes        
                   
                   
                   
                   
                 
                 
Parent Signature ___________________________________________________________________________________