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OBBHA Youth Registration Form
If you require more information on the Ottawa Blues Ball Hockey Registration, please contact Trevor Polk at
or by calling or texting (613) 795-9376
Which season are you interested in?
Fall (Septempber to December)
Winter (January to April)
Players Last Name (ex. Smith)
Players First Name (ex. John)
Players age as of December 31st
Are you a goaltender?
Phone Number (ex. 613-555-5555)
Method of payment ?
Credit Card (Paypal)
Cheque ( Simply hand out on your first session)
Cash ( Simply hand out on your first session)
The OBBHA Inc., I, the undersigned parent/guardian, hereby release and discharge (OBBHA) from any and all claims, demands, actions and causes of action which I may have for any damages, loss or injury suffered by my child or incurred by me and resulting directly of indirectly from the participation of such child in such program. I hereby undertake to indemnify the OBBHA, its agents and staff and hold them from and in respect of any and all claims, demands, actions and/or proceedings which may be brought about as a result of participating in the aforesaid program. Moreover, any cost and expenses incurred in defending any and all claims, demands, actions and proceedings shall be the responsibility of the said parent / guardian. Furthermore, I give permission for my child's photo to be used in any OBBHA promotional material, including the website player's profile stats.
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