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2023/24 Registration Form
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> 2023/24 Registration Form
Step 1
Personal Information
Step 2
Programs and Products
Step 3
Consent
Step 4
Payment
* Indicates Required Field
Player Information
Are you a returning Player?
Yes
No
First Name *
Last Name *
Birthdate *
Access Code
(Only returning players need to enter the Access Code.)
What's my Access Code?
Email Address *
Hockey Canada Number
Gender
Not Specified
Male
Female
Height
0
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ft.
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in.
Weight
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lbs.
Shot *
Left
Right
Position *
Goalie
Left Defense
Right Defense
Defense
Left Wing
Center
Right Wing
Forward
N/A
Player
Last Team *
Address *
City / Hometown *
Postal Code *
Zip Code *
Phone Number *
Secondary Phone Number
Home Association *
North Dundas Minor Hockey
South Dundas Minor Hockey
South Grenville Minor Hockey
Kemptville Minor Hockey
Brockville Minor Hockey
Leeds Minor Hockey
Smiths Falls Minor Hockey
Other
What level did you play in 2022/2023 season? *
AAA
AA
A
B Rep
B House
C House
Tier 1
Tier 2
Tier 3
Parent/Guardian Information
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Email Address *
Verify Parent/Guardian Email Address *
Parent/Guardian Phone Number *
Parent/Guardian Secondary Phone Number
Use Above Address
Parent/Guardian Address
Parent/Guardian City
Parent/Guardian Province / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Parent/Guardian Postal / Zip Code
Player Hockey Sock Size *
18 - XS
22 - S
26 - M
30 - L
This would be for the 2023/2024 Season
Player Jersey Size *
Youth Medium
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Goalie Youth
Goalie Adult
This would be for the 2023/2024 Season
Player Pant Shell Size - *
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult Extra Small
This would be for the 2023/2024 Season
Player Track JACKET Size *
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2XL
This would be for the 2023/2024 Season
Player Track PANTS Size *
Youth Small
Youth Medium
Youth Large
Youth Extra Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult 2XL
This would be for the 2023/2024 Season
Parent/Guardian 2 Information
Parent/Guardian 2 First Name *
Parent/Guardian 2 Last Name *
Parent/Guardian 2 Email Address *
Parent/Guardian 2 Phone Number *
Use Above Address
Parent/Guardian 2 Address
Parent/Guardian 2 City
Parent/Guardian 2 Province / State
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Parent/Guardian 2 Postal / Zip Code
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