Player First Name

Player Last Name

Player gender
--select one--FemaleMale

Team you are registering to:
--select one--Youth (Beavers)MC2MR1OTM2OT3

Your email

Your Telephone number

Your Address

City

Your Province

Your Postal Code

Date Of Birth (DOB)

League identification OSA #:

Health Card Number OHIP #:

Who is submitting this form:

ID Photo (Driver's Licence)

Your message (optional)

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