Canadian Regionals > 2016-2017 > Eastern Region > 2016-17 Northumberland Regional > 2016 Registration (International Silver Stick)

2016 Registration

Thank you for entering our Silver Stick Regional Qualifier (December 2-4, 2016)

You have two payment options.

1. Pay your tournament fee online (In-full) using a credit card or PayPal. This is the best option if you will need hotel rooms. Please see hotel page on this site for more details.

or

2. Pay online, a $200 non-refundable deposit with balance to follow by cheque.
The balance can be sent made payable to the “Northumberland Minor Hockey Association or “NMHA” to:

Northumberland Minor Hockey Association
750 D'Arcy St.,
Cobourg, ON
K9A 0G1

Please add team name and division to the memo line, Include "Silver Stick"

Payment Info

Please see the payment options below. If your team will require Hotel Rooms, it is recommended you choose the Pay In-full Option.

Tournament Division^*

Required

Which division are you registering for?

Payment Amount^*

Required

Pay Deposit Now + Balance Later --or -- Pay In-Full Now

Payment Type^*

Credit Card or Paypal Payment In-Full Now
Credit Card Deposit Now - Balance by Cheque Later

Required

Your Team Information

Team Name^*

Required

i.e Northumberland Nighthawks

Association^*

Required

i.e Northumberland Minor Hockey Association

Branch^*

Required

i.e. OMHA, Alliance, GTHL etc.

Category^*

Required

AA, A, B, C

League^*

Required

i.e. Tri-County, York-Simcoe, GTHL etc

Jersey Colours:

NOTE: Bring both sets of jerseys to the tournament in case of colour conflicts!

Home^*

Required

Body Colour / Trim

Away^*

Required

Body Colour / Trim

Manager Contact

Note: In all cases the manager will be utilized as the primary contact. Please ensure that the person declared as manager has a functioning fax machine and e-mail address as communication is done primarily through these avenues.

Manager^*

Required

Address^*

Required

City^*

Required

Postal Code^*

Required

Home Phone^*

Required

Example: ###-###-####

Work Phone

Example: ###-###-#### x###

Email Address^*

Required

Your registration Confirmation will be sent to this address

Fax #

Example: ###-###-####

Coach Contact

Head Coach^*

Required

Address^*

Required

City^*

Required

Postal Code^*

Required

Home#^*

Required

Example: ###-###-####

Work#

Example: ###-###-#### x###

Email Address

Example: [email protected]

Fax #

Example: ###-###-####

Roster

Please add your roster if available. We will require a list of player names and #'s for program printing.

Goalie Name + Jersey #

Player Name + Jersey #

Other: Hotel Rooms

Please see the Hotel information page on this website. Hotel Rooms are released to the teams once payment In-Full is received. Rooms are subject to availability.

Will your teams require hotel rooms?

If yes, How many rooms?

Rooms based on Availability

By checking the box below, the Team Manager/Head Coach on behalf of his/her team releases any sponsors of the above mentioned tournament, its officials, arena management and all concerned with the tournament, from any liability for any injury or accident which may be incurred by any players or team official while participating in, or coming to, or going from, the tournament and accepts all decisions of the tournament committee as final.

We hereby acknowledge the deposit amount of $200 of the tournament entry fee is non-refundable and understand the following;

Any team withdrawing from the tournament 30 days or less from the start of the tournament shall forfeit all paid monies.

Initial acceptance to the tournament is granted upon payment completion of the tournament entry fee [In-Full] unless contacted directly by tournament organizers stating otherwise. Final acceptance is granted once a team submits an Approved Roster to verify the team's eligibility to participate in the Northumberland Silver Stick Regional Tournament.

The Northumberland Regional Silver Stick Tournament Committee reserves the right to deny entry into the tournament, without reason. Should this situation arise, all entry fees (including the deposit) shall be refunded to the payee.

Balance of tournament fees are due no later than October 15th to guarantee a spot in the tournament.

Hotel Rooms are subject to availability.

I agree to the terms and conditions stated above^*

2016 Registration, 2016-17 Northumberland Regional, Eastern Region, 2016-2017, Canadian Regionals (International Silver Stick)

Payment Info

Your Team Information

Jersey Colours:

Manager Contact

Coach Contact

Roster

Other: Hotel Rooms

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