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Please fill out and return by fax to -- (902) 455-2427
Mail Registration Form and Payment to:
Bluenose Cup Registration
121 Haddad Drive Lower Sackville, NS B4C 4G6
Cheques are made payable
to Nova Scotia Selects
| Spring Hockey Tournament 1998 / 1999 / 2000 / 2001 / 2002 / 2003 | | Bluenose Cup | Tournament Date: | May 20-23, 2011 | Tournament Location: | St. Margaret’s Centre, Tantallon & BMO
Arena, Bedford Directions To Arena From | | | Tournament Cost | $ 975.00 /per team | Participating
Teams | 1998 / 1999 / 2000 / 2001 / 2002 / 2003 / 2004 Jamboree | | | The tournament format will be a round robin with
the top 2 teams meeting in the final. Each team is guaranteed 4 games. | |
The registration fee for this tournament is $975.00 payable
to NS Selects Hockey. Please mail registration and payment to: Danielle Peveril / Selects Hockey | 121 Haddad Drive | Lower Sackville, NS | B4C 4G6 |
Please Note: Proof of insurance and a complete
team roster including player birth dates is required with registration. Only teams that have submitted
registration and payment will be permitted to participate in the tournament. Team Registration | | | Team Name: | Team Hometown: | Team Website | Coach: | Coaches Phone #: | Assistant
Coach Name: | Coach Email : | Assistant
Coach Name: | Coaches Phone #: | Assistant
Coach Name: | Coaches Phone #: | Team Address | Street / PO Box | | City | Province | Postal Code: | |
Team
Registration | Player Name | Player Number | Birth Year | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
In consideration
of being allowed to participate in the Selects Hockey AAA Spring Tournament, the undersigned agrees and acknowledges, on behalf
of the team registered participating in the 2011 Selects Hockey AAA Spring Tournament, that NS Selects Hockey will not be
held responsible for any accidents, injury or loss suffered by the team members and releases and holds harmless NS Selects
Hockey of any and all claims, demands, actions, and proceedings which may be brought by team members against NS Selects Hockey
as a result of participating in the aforesaid program. Date: _________________
Signature: ____________________________
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