Online Registration | Pembina Valley Minor Hockey Association

Online Registration

Personal Information
Name	Program
Address			Date of Birth
City		Province		Postal Code
Telephone	--		Email

Hockey Information
Previous Team
Position
Height	ft in	Weight	lbs	Shot Left or Right

In Case of Emergency
Contact			Relation
Telephone	--		Alternate #	--
Medical Number			Personal Health Number
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Use this form for

Directors Cup, Male/Female POE, Challenge Cup, Bantam Development, Pee Wee Skills, Midget Female AA