Belleville Minor Hockey is pleased to announce again that we will be running an INITIATION PROGRAM during the Summer Hockey time frame.

The Program will consist of 1 hour a week of hockey skill building for players 7 years old and younger. (No prior skill required)  This is a great opportunity for kids to "get on the ice"  This fun interactive hour again is for kids to try it out.  Using some of our "seasoned" players from both boys and womens hockey, this is an opportunity for them to give back as well.

BMHA can accommodate a maximum of 20 players so please make sure that you register early to guarantee a place.

Cost: $85.00 per child
                                

Belleville Minor Hockey Association (BMHA)

2012 Summer Hockey Initiation Program Registration Form
($25.00 Fee for replacement receipts)

• Registration deadline is June 4, 2012, registrations received after June 4, 2012 will be placed on a waiting list and assigned to a team (space permitting).
• Registration is not considered complete until full payment has been received by the BMHA.  The BMHA no longer accepts personal cheques, you may register online using a Visa / Mastercard or in person at the BMHA Office using Cash, Interac, Visa or Mastercard.
• The BMHA has an established Code of Conduct for Players, Coaches and Parents as published in the BMHA Rules and Regulations booklet. As the parent / guardian of the registered player, you agree to abide by these policies.
• By completing the player registration form, I am indicating that I have read and understand the above.

Completing the Online Registration Form:

• Please complete all of the following sections, fields marked with a * are required .
• Upon completion of the online player registration form, you will be prompted with a payment page.  Please follow instructions on the screens provided.  A payment and registration receipt will be sent via email to the email address provided.
• With the exception of the E-Mail address, all fields (unless otherwise indicated) refer to the player. Please enter Parent/Guardian information in the fields provided.

Player Name, Address and Contact Information
(Enter Parent/Guardian E-Mail address in e-mail address field):

*	First Name:
*	Last Name:
*	Address:
	Address 2:
*	City:
*	Province:
*	Postal Code:
*	Email Address:
*	Phone:
*	Players Date of Birth (YYYY-MM-DD)
* Players Gender Male Female
*	Parent/Guardian (1)
*	Parent/Guardian (1) Alternate Phone Number
	Parent/Guardian (2)
	Parent/Guardian (2) - Alternate Phone Number
	Are there any medical conditions the BMHA should be aware of?
* Players preferred position is: Forward Defence Goaltender
*	Registration Fee	$85.00
	Total:
*	Enter the code displayed: