NEW SAMHA/Raiders/Rep Registration Package

Size: px

Start display at page:

Download "NEW SAMHA/Raiders/Rep Registration Package"

Ellen Turner
5 years ago
Views:

1 NEW SAMHA/Raiders/Rep Registration Package This package consists of all forms needed to register for SAMHA, SAMHA Rep and Raiders. This package is for NEW players who currently reside within SAMHA residential boundaries. Please only fill out the forms that are applicable to your child. Please see below for applicable forms needed. SAMHA: SAMHA Registration Form PIPA HA Parent Declaration Form - (you must provide proof of residency) SAMHA REP: SAMHA Registration Form PIPA SAMHA Rep Team Agreement Form HA Parent Declaration Form (you must provide a proof of residency) RAIDERS: SAMHA Registration Form PIPA Raiders Club Team Agreement Form HA Parent Declaration Form (you must provide a proof of residency) Once you have completed these forms please mail them to PO Box #47, St. Albert, AB T8N 1N2 or drop them off at the SAMHA office located in front between the Akinsdale and Kinex Arena - 66 Hebert Road, St. Albert *** along with a copy of your child s birth certificate and proof of residency (a current utility bill, Driver s licenses will not be accepted)*** ALL SKATE TIMES AND LOCATIONS WILL BE POSTED ON THE SAMHA/RAIDERS WEBSITE or NO PHONE CALLS WILL BE MADE. Please make cheques payable to SAMHA. Office Hours: Monday Friday 1:00 pm 4:00 pm The SAMHA office is closed Weekends and Holidays. The office will be closed for two weeks starting July 13/12 and will re-open July 30/12. If you have any questions, please do not hesitate to contact the office at addresses, registration fees and other useful information can be found on our websites or (Revised April 2012)

2 ST. ALBERT MINOR HOCKEY ASSOCIATION PO BOX 47, St. Albert, Alberta T8N 1N2 PHONE (780) FAX (780) Initiation 1 ( ) $ Initiation 2 (2006) $ Novice ( ) $ Atom ( ) $ Peewee ( ) $ Bantam ( ) $ Midget ( ) $ **Please note these fees do not include tryout or late fees, for a full list of registration fees, please see the website ** Player s Name: Player s Address: City: Postal Code: Home Phone: Season Date of Birth: (yyyy-mm-dd) Address: Position: Shoots: R L Last Year s Team: Club/REP Tryouts: Y N Import/Non Resident Y N Gender: M F If you are a female player will you be playing: Coed Female only Mother s Name Address: City: Postal Code: Cell Phone: Home Phone: Work Phone: Father s Name Address: City: Postal Code: Cell Phone: Home Phone: Work Phone: Emergency Contact Name: Phone: Parent/Guardian s Name (print): Parent/Guardian s Signature: Player s Name (print): (only if over 18 yrs old) Player s Signature: Date: For Office Use Only Date: Registration Requirements PIPA PV Form PTT Form Release Birth Certificate NTTO Rep/Club Form Parent Decl. D/L Utility Bill Reg Form Player Movement Other Fee Description Amount Date Payment Amt Method Registration Fee 1 Late Fee 2 Try Out Fee C R 3 Other 4 Notes: Receipt # Conditions Hockey Alberta and its Local Minor Hockey Associations (LMHA) recognize and agrees to abide by Hockey Alberta and its LMHA and CHA constitution, their regulations, their playing rules and all duly approved amendments thereto. Every member recognizes Hockey Alberta and its LMHA as being the sole organization entrusted with the management and organization of hockey throughout the territory of Hockey Alberta and its LMHA. Every Hockey Alberta and LMHA member recognizes that all information provided herein is true and valid. Any false information provided herein may lead to the application of sanctions as provided in various regulations. All registrations are subject to review by the Registrar and no registration will be approved until all fees are paid and required documentation is received. Registration is undertaken with the understanding that additional team fees and/or fundraising may be required depending on the level of play.

3 ST. ALBERT MINOR HOCKEY ASSOCIATION PERSONAL INFORMATION PROTECTION ACT NOTICE AND CONSENT PLAYER (print name) BIRTH DATE The Purpose of this notice and consent is to inform you of the use to which player information, pictures and game information and game statistics will be made and to obtain your consent for such use. 1. The player information is collected and maintained so as to properly coordinate and operate the St. Albert Minor Hockey program and is also provided to Hockey Alberta and Hockey Canada or any league the player's team plays in, for registration, recording statistical information and insurance purposes. 2. Player's names, information, data, photos and comments may also be used in team or league newsletters, annual reports, St. Albert Minor Hockey Association and Hockey Alberta web sites, radio, newspaper and other hockey or local publications. 3. Individual and team photos may be taken and displayed in the local newspaper and in local arenas and the offices of St. Albert Minor Hockey Association and yearbooks and other reports and advertisements prepared by St. Albert Minor Hockey Association. 4. Player's names and parents/guardians telephone, and other information may be used for the purposes of team, league and for St. Albert Minor Hockey Association communication and transportation matters and services. 5. Player's names may be included on lists for the purposes of team placement and for tracking player statistics by the team, leagues, St. Albert Minor Hockey Association, and Hockey Alberta and such statistics may be displayed on their websites. 6. This Consent shall remain in force for as long as the Player is a member of St. Albert Minor Hockey Association and need only be signed once. I hereby consent to the above: Signature of Parent/Guardian Date Parent/Guardian (print name)

REP HOCKEY REQUIRMENTS (NO EXCEPTIONS) To All Parents: Being a member of a SAMHA s Representative Hockey team will place great demands on both a family s time and financial obligations.

5 REP HOCKEY REQUIRMENTS (NO EXCEPTIONS) To All Parents: Being a member of a SAMHA s Representative Hockey team will place great demands on both a family s time and financial obligations. Before paying your REP tryout fee, please ensure that you can commit to the following if your child makes one of the Representative (REP) Hockey Teams: PROPOSED TEAM BUDGETS: Atom A/PeeWee A $1400/player Atom AA/PeeWee AA $1400/player EQUIPMENT: Navy Blue Gloves, Navy Blue Pants, and White Helmet are MANDATORY for Midget and Bantam Raider Club levels AND Strongly encouraged at the PeeWee and Atom REP levels. DRESS CODE: All REP team members must comply with the REP dress code. PRACTICES ARE NOT OPTIONAL Child s name: (please print) Level trying out for: (PeeWee or Atom) *********** I have read and understand the above Signature of Parent Date Print Parent s Name (Revised February 2008)

CLUB REQUIREMENTS (NO EXCEPTIONS) To All Parents: Being a member of a Raider s Hockey Club team will place great demands on both a family s time and financial obligations.

6 CLUB REQUIREMENTS (NO EXCEPTIONS) To All Parents: Being a member of a Raider s Hockey Club team will place great demands on both a family s time and financial obligations. Each player will pay a $100 Club fee if selected to a Club Team. Each Club Team will be required to provide a minimum of six (6) parent volunteers and six (6) sponsors for the program for the John Reid Memorial Bantam AAA Tournament and, in addition, each family agrees to work a minimum of one shift at the Tournament. Before paying your Club tryout fee, please ensure that you will commit to this obligation, the following Team fees, and all other Club obligations if your child makes one of the Raider s Hockey Club Teams: PROPOSED TEAM BUDGETS/FEES: Bantam AA $2500-$3500/player Bantam AAA (M & F) $2500-$3500/player Midget AA $2500-$3500/player Midget AAA 15 $2500-$3500/player Midget AAA (M & F) $5000-$6000/player (Please note that players that are still on the Raiders MAAA male roster at the time of the camp will pay an additional $ for the Jasper conditioning camp) EQUIPMENT: Navy Blue Gloves, Raiders Shells, and White Helmet are MANDATORY for all Club teams. DRESS CODE: All Club team members must comply with the Club dress code. Team jackets from approved suppliers only are MANDATORY. Note: Player s name/phone number/ and other information may be used for the purposes of team, leagues, and for any SAMHA and Raiders communications which they deem appropriate, including transmittal to Junior Hockey Clubs, and transportation, all other matters and other services. PRACTICES ARE NOT OPTIONAL RELEASES & REFUNDS: I agree that I am not entitled to a Release or a refund from the Raiders Hockey Club or St. Albert Minor Hockey Association of any funds that I might have paid to them until I have fully paid all of my Team fees and completed all of my Team obligations. I agree that all refunds shall be applied against any outstanding Team fees. Child s name: (please print) Level trying out for: (Bantam or Midget) *********** I have read and understand and agree to all of the above Signature of Parent Print Parent s Name Date (Revised December 2011) {Client Files/9311/7/E DOC }

NEW SAMHA/Raiders/Rep Registration Package

NEW SAMHA/Raiders/Rep Registration Package This package consists of all forms needed to register for SAMHA, SAMHA Rep and Raiders. This package is for NEW players who currently reside within SAMHA residential