Clone of 2025-SpringSummer Registration

Player Name

First NameLast Name
Player Birth Date

MonthDayYear
Current team & Level
Player Position
Division
Registering as individual or part of a team
Team or Coaches Name (if applicable)
Parent Contact Name

First NameLast Name
Parent Contact Phone
Format: (000) 000-0000.
Parent Contact E-mail
example@example.com
Parent Contact Name

First NameLast Name
Parent Contact Phone
Format: (000) 000-0000.
Parent Contact E-mail
example@example.com
Registration Fee (To be e-transferred to joe@londoncobrashockey.ca)
Jersey Size
Preferred Number
Goalie Cut
Special Requests (We will try our best to accommodate requests but can not guarantee)
I acknowledge that registration is NOT completed until registration fees have been received via e-transfer to joe@londoncobrashockey.ca. Please ensure your players name is included in the "message line" of the transfer
Should be Empty: