2022 Hockey PEI High Performance Program - Player Registration Form

HIGH PERFORMANCE PROGRAM - PLAYER REGISTRATION FORM
General Info

Please fill in all of the required information below:
Players Name *

First Name Last Name
Date of Birth *

Month Day Year
Division you are registering for: *
Player Contact Info

Please fill in all of the required information below:
Home Address *

Street Address

City Province

Postal / Zip Code
Players Cell Phone *

Area Code Phone Number
Players Email
example@example.com
What brand of Phone does the player have (For app creation purposes) *
Additional Player Info

Please fill in all of the required information below:
Height *
Weight *
Shot *
Position *
Please enter the team you played for during the 2021-2022 season: *
Please enter the team/league you hope to play for/in for the 2022-2023 season: *
Player Clothing Sizes

Please fill out the following information:
Short Size: *
Track Suit Size: *
Shirt / Sweater Size: *
Parent / Guardian Contact Info

Please fill out the following information:
Mother / Guardian name: *

First Name Last Name
-> Email *

Confirmation Email Re-Enter Mother / Guardian #1 Email
Father / Guardian name: *

First Name Last Name
->Email *

Confirmation Email Re-Enter Father / Guardian #2 Email
Emergency Contact + Medical Info

Please fill out the following information:
Emergency Contact Person in case of emergency other than parent/guardian: *

First Name Last Name
Emergency Contact Phone Number *

Area Code Phone Number
Please list any allergies or current/past injuries or medical information that you feel our certified and trained Medical Staff/Athletic Therapists should be aware of (Please note this information is kept confidential):
*Any medical condition or injury problem should be checked by your physician before participating in a hockey program.

I understand that it is my responsibility to keep the HPP Management team advised of any change in the above information as soon as possible and that in the event no one can be contacted; HPP Management will take my child to hospital/MD if deemed necessary. I hereby authorize the physician and nursing staff to undertake examination, investigation and necessary treatment of my child.

I also authorized the release of information to appropriate people (coach, training staff, physician, etc) as deemed necessary.
Payment & Signature

Please complete the following steps below:
A registration fee of $225.00 is due to the Hockey PEI office (40 Enman Crescent, Charlottetown, PE) upon completion of this form. The Player application form will not be processed until we receive payment. Do you agree to pay in full before the deadline stated below? *
How will you be paying?
If paying by credit card, it must be done over the phone by contacting the Hockey PEI Office. 902-368-4334
PLEASE NOTE: If you are sending an e-transfer payment to Hockey PEI (info@hockeypei.com) please include the Players name and division registering for under the message of the e-transfer!

*Please, no phone calls. Use the contact info below should you have an inquiry.
DEADLINE TO SUBMIT FORM AND PAYMENT OF $225.00 IS DUE WEDNESDAY, APRIL 13TH, 2022
Signature of Parent or Guardian Required below:
For more information on Hockey PEI's High Performance Program please email:

Kris Macphee

Technical Director

kris@hockeypei.com

Tanner Doiron

Manager, Hockey Operations & Communications

tanner@hockeypei.com

*Please, no phone calls. Use the contact info above should you have an inquiry.
Should be Empty:

HIGH PERFORMANCE PROGRAM - PLAYER REGISTRATION FORM

General Info

Player Contact Info

Additional Player Info

Player Clothing Sizes

Parent / Guardian Contact Info

Emergency Contact + Medical Info

Payment & Signature