2009  Winter Adult Hockey League Registration Form
A, B, & C Leagues
Please print this page, fill out all information and send to:  
ICE Arena, 5165 E. Remus Rd., Mt. Pleasant, MI 48858
Player Name:                                                                                

Address:                                                                                                

City:                                          State:                  Zip:                                

Phone:(        )                                   

Email:                                                            Date of Birth:                                 
 
League:     A              B                C

Are you on a protected list?                YES                NO

If yes, which team?                                                                        

Position:               Forward                        Goalie

Skill Rating:        1                2                3                4                5
                Lowest                                                            Highest

Are you a team representative?        YES        NO        
If yes, please submit team representative information form.
Payment Information        Amount Enclosed:                        












All Players MUST PAY IN FULL at time of Registration

USA Hockey Insurance can also be purchased at :
www.usahockeyregistration.com for $35
A copy of USA Hockey registration must accompany this form.
If you played in the Fall League you do NOT need to re-do your
USA Hockey Registration

*** Due to MAHA Policy, the ICE Arena can no longer process USA Hockey
Registration on your behalf***

Refund Policy: Prior to 1st game: 1/2 of collected fees
  After 1st game: Permitted only for extreme circumstances

Please make all checks payable to "Smooth Surfaces"

Credit Card Information:
Circle One:        Visa        MasterCard        Discover

Card No:                                                          Exp.                                

Signature:                                                  

REGISTRATION DEADLINE:   January 11, 2009

*The League Director reserves the right to move players to
a more appropriate division based on skill level*
FEES:
Full Payment
Player
$160.00
Student
 $ 140.00
Goalie
$100.00
Want to Put Your Own Team Together??
Click HERE for Team Rep. Form