Mighty Ducks Hockey League

Registration Form

Personal information Player’s First Name
Last Name:
Street Address:
Zip Code:
Birth Date:
Parent/Guardian:
City:
School:

Which elementary school do you live near?

Closest School

AJ Katzenmaier: Greenbay: Howard A Yeager: Marjorie P Hart: North Elementary: South Elementary:

What position(s) do you normally play? (check all that apply) Forward: Defense: Midfield: Goalkeeper:

Uniform Size: Youth Small Youth Medium Youth Large Small Medium Large Extra-Large

Uniform Size:

I, the parent or guardian of the minor registrant, agree that the registrant and i will abide by all the rules of the Mighty Ducks Hockey League (MDHL). In recognizing the possibility of physical injury associated with hockey and in consideration for the "League" accepting the registrant for its hockey programs and activities, i hereby release, discharge, anr/or otherwise indemnify MDHL, their employees and associated personnel and volunteers, including the facilities used for practices and games, against any claim by or on behalf of the registrant as a result of the registrant's participation in the programand/orbeing transported to or from MDHL sponsored activities, wich transportation. By entering your name below, i hereby agree and authorize the above. In addition, By entering your name below, i also acknowledge that i have read the cancellation policy and agree to its terms.

Parent/ Guardian Signature:
Date: