Intent to Play 2021-2022 (Belmont, Aylmer, Dorchester Blazers)

Print Intent to Play 2021-2022

Please complete the form below if you intent to register for the upcoming 2021-2022 season.

Players Name^*
Players Date of Birth: Year^*
Month^*
Day^*
Parent/Guardian Name^*
Parent/Guardian Phone #^*

Home address

Please complete your address

Street Address^*
City/Town^*
Postal Code^*

Email address^*
Are you a returning player^*
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Please check one
Team^*
Liability Waiver I acknowledge, personally and on behalf of my child, heirs and any of his /her/ my legal representative, that BADGHA, it’s agents officials, sponsors, and representatives shall not be held liable for any death, injury, loss, cost, or expenses arising from participation in any activity directly or indirectly associated with the previously mentioned hockey club occurring on or off the ice. My child has permission to participate in the BADGHA Activities and I give the BADGHA permission to render medical attention to my child should it be necessary. It is further agreed that all rules and regulations will be abided by the participant and parent/guardian.

I agree to the terms and conditions stated above^*

Human Validation

Check The Box ^*

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Sat Jun 19, 2021

Printed from badgha.com on Saturday, June 19, 2021 at 5:53 PM