Mississauga Roller Hockey Association

2011 Mississauga Roller Hockey Association
Individual Registration Form - Adult Divisions

Player's Name
Street Address
City, Province, Postal Code
Email Address
Home Phone Number
Cell Number
Date of Birth
Sex
Allergies/Health Problems
Division (Select One)
Most Recent Ice Hockey Experience (select one):
Position (Select One)
Date

The cost per player is $225, $175 for goaltenders (plus HST). Please make cheques payable to M.R.H.A. Payment can either be mailed or arrangements can be made to meet prior to April 15th.
Mail to: MRHA, 700 Humberwood Blvd. Apt, 2618, Etobicoke, Ontario M9W7J4

2011 Mississauga Roller Hockey Association Individual Registration Form - Adult Divisions

2011 Mississauga Roller Hockey Association
Individual Registration Form - Adult Divisions