Registration Form Player's First Name: Last Name: Street Address: City: Zip Code: Birth Date(mm/dd/yyyy): Gender: Female Male Grade: Pre-School 1st 2nd 3rd 4th 5th Which elementary school do you live near? Closest School: AJ Katzenmaier Greenbay Howard A Yeager Marjorie P Hart North Elementary South Elementary Which elementary school do you live near? Forward Defense Midfield Goalkeeper Which elementary school do you live near? Youth Small Youth Medium Youth Large Small Medium Large Extra-Large Permission to Play 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, and/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,which transportation By signing below, I herebyagree andauthorizethe above.In addition, by signing below, lalso acknowledge that I have read the cancellation policy and agree to its terms. Parent/Guardian signature: Date:
