Peterborough Minor Ball Hockey League(PMBHL) Registration Form
The PMBHL is a member of the Ontario Ball Hockey Association and National Ball Hockey Association of Canada with opportunities to qualify for Provincial, National and International Championships.

Program with OBHA Certified Referees:

- One game per week Mon - Fri. at Millbrook arena, Championship Day Celebration & Awards, Limited dental & medical insurance

Mandatory Equipment:

- CSA approved hockey helmet with full face protection, Hockey gloves, soccer-style shin pads, and athletic cup.
Soft Elbow and knee pads are also recommended.

Players in the same family of the same division will be placed on the same team, however, we can no longer accept friend requests.
Player Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Primary Parent/Guardian Name *
Your answer
Primary Parent/Guardian address *
Your answer
Primary Parent/Guardian Phone# *
Your answer
Primary Parent/Guardian Email *
Your answer
2nd Parent/Guardian Name *
Your answer
2nd Parent/Guardian Phone *
Your answer
2nd Parent/Guardian Email
Your answer
Division Signing up for *
Tyke (2012-2014)
Novice(2010-2011)
Atom (2008-2009)
Peewee (2005-2007)
Row 1
Years of Experience (ice or ball hockey) *
0-1 yrs.
2-4 yrs.
5-7 yrs.
over 7
Row 1
Returning PMBHL Player *
Yes
No
Row 1
My Child plays in the position of *
Forward
Defense
Goalie
Any
Row 1
Rate your child from 1(just beginning) - 10 (excellent) *
Ice Hockey Level *
AAA/AA
A/AE/REP
House League
Not Played
Row 1
Jersey Size *
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Row 1
Photos/Video of my child, in both print and electronic format, may be used by PMBHL for the purposes of marketing and promotion. *
yes
no
Row 1
We always need help to make the league run. Are you interested in helping? *
Registration Fees - Select appropriate one - payable upon completion of registration. *
Registration Fees - Please pay them at the time of completing this form so we can track them. **e-transfer question, if needed, is what sport are we playing and the answer is ballhockey, no spaces. *
WAIVER In consideration of the PMBHL and County of Peterborough (County) and the Minor Sport Association (MSA), Club or Incorporated Body specified on this form permitting me/our child to participate in the Association, Club or Incorporated Body, we hereby promise to indemnify and save harmless the City, its Council and all its employees and servants under the MSA, Club or Incorporated Body and its members from and against all claims, demands, actions, and proceeding, by whomsoever made or brought, in respect of any costs, expenses, loss, damage, or injury, including death arising by reason of or in connection with my/our child’s participation in the said activities, and hereby release and forever discharge. The County, it’s Council and its employees and servants and the MSA, Club or Incorporated Body and its members from and against all claims and demands whatsoever which we, our child, our or his heirs, executors, administrators or assigns, can, share or may have by reason of my/our child/s participation in such activities, or by reason of the provision of medical care to me/him/her. *
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