House League Development Program PLAYER Registration form

Official Player Registration Form

* Indicates required field

Player Name *

First

Last

Contact Email *

Phone Number *

Date of Birth *

Home Association *

Team Name & Level (2024-25 Winter Season - i.e.: Embrun Panthers U11B) *

Parent/Guardian Name *

First

Last

Level Registering for Spring 2025 *

Preferred Jersey Number (provide 3 options) *

Jersey Size *

Preferred Language of Instruction *

English French Both

Method of Payment *

E-transfer Cheque via mail (payable to Marc Andre Ranger Enterprises) Other

I understand that my child's spot will only be held once a $100 deposit payment is sent (and received by the association) and will be fully confirmed after registration fees have been paid in full. All registration fees must be paid no later than March 15. *

Yes

E-transfers to be sent to [email protected]

Mail cheques payable to Marc Andre Ranger Enterprises to
Marc Andre Ranger Enterprises
c/o Marc Andre Ranger
1967 Montmere Avenue
Orleans, ON
K4A 0E3

Additional Notes or Comments (i.e.: Friends/teammates/siblings also registered in program; requests are not guaranteed) *

By signing/submitting the entry form, the parent, guardian or undersign individual on behalf of the player, parents, et al release Marc-Andre Ranger Enterprise, Pirates organizers, employees, its officials, arena managements and all parties concern with the events of any liability, injury or accident that may occurred by any players, coach, parents participating in or traveling to and from this event.
En apposant sa signature, la personne signant le document degage les organisateurs, les commanditaires, ses officiels, la direction et le personel de l'arena et toute autres personnes affectees au tournoi, de toutes responsabilites en cas de blessure ou accident des participants, personel d'entraineurs ou parents durant le voyage d'arrive ou retour ainsi que pendant le eventement.

Submit