2023 4on4 Hockey - U13 Player Wait List (Kitchener Minor Hockey)

Player Information

Please complete Player Information

Participant's First Name^*

Required

Participant's Last Name^*

Required

Enter the players last name

Participant's Birthdate (Born in Years 2010-2011)^*

Required

Click on Calendar to Select

Gender^*

Male
Female
Prefer Not To Say

Required

Participant's Address^*

Required

City^*

Required

Postal Code^*

Required

Sample: X0X 0X0

Parent / Guardian Name^*

Required

Parent/Guardian Phone Number^*

Required

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

Parent/Guardian Email Address^*

Required

Example: [email protected] - Your submission will be sent to this address

Player Team Information

Please provide any playing history and team friend request.

Team Played for Last Season^*

Required

Enter the team name the player played for last season (if played in the league) or indicate didn't play.

Alliance/OMHA Level of Hockey Played Last Season^*

Required

Select the level of hockey played last season

OWHA Level of Hockey Played Last Season^*

Required

Select the level of hockey played last season

Same Team Request (One Name Only)

Please enter first and last name of ONE (1) friend

Volunteer Information

Please let us know if you are able to volunteer to be a coach for our 4on4 season.

Volunteer to Help on Team Bench^*

YesNo

Required

Please indicate if you will be able to volunteer as a coach

Name of Volunteer (if Applicable)

Please Select Team Bench Position

Head Coach
Assistant Coach
Not Applicable

Please select one of the above, if applicable

Coaching Certification

Respect in Sport
Coaching CS1 / C2
Coaching DS1
Trainers (Current)

Please Check All That Apply

2023 4on4 Hockey - U13 Player Wait List (Kitchener Minor Hockey)

Player Information

Player Team Information

Volunteer Information

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