Registration Form 

(click here for printable copy)

PLEASE COMPLETE AND SEND ME A COPY PRIOR TO OCTOBER 28TH 2011

SCHOOL NAME:  _____________________________                                     TEAM NAME:___________________________

ADDRESS:      _______________________________                                      CITY: _________________________________

PROVINCE/STATE:____________________________                                    POSTAL/ZIP CODE: _____________________

SCHOOL TELEPHONE:   (        )  __________________                                   FAX:   (        )  ___________________________

CONTACT PERSON:       NAME: __________________________

                                           PHONE:__________________________

                                           EMAIL ADDRESS:  ________________________________________

(IF DIFFERENT FROM ABOVE PLEASE COMPLETE THE FOLLOWING)

ADDRESS:  _______________________                                                            CITY: ________________________________

PROVINCE/STATE: _____________________                                                   PHONE:  (         )   _____________________________

CONVENOR OF YOUR LEAGUE:   ________________________                  CONVENOR'S SCHOOL:  ______________________

PLEASE CIRCE THE APPROPRIATE NUMBER

1.  ENCLOSED IS THE TOTAL ENTRY FEE OF $600.00    (Payable to “NDA Hockey Tournament”)

2. OUR TEAM WILL NOT BE ABLE TO PARTICIPATE IN THE 38th ANNUAL NDA TOURNAMENT,  BUT WOULD LIKE TO REMAIN ON THE MAILING LIST FOR FUTURE YEARS.

** PLEASE NOTE: THE DEPOSIT WILL BE REFUNDED IF AN APPROPRIATE REPLACEMENT IS PROVIDED.

         Please Mail Cheque to:  

Widdifield Secondary School

c/o Anthony Loreto

320 Ski Rd. North Bay, Ontario.  P1B 7R2

loretoa@ndahockeytournament.com