SCSHA NEW PLAYER REGISTRATION

FALL SEASON

 

 

PLAYER’S NAME:______________________________________________      SEX:   M     F

                                                (LAST NAME)                 (FIRST NAME)            (MIDDLE IINITIAL)             (CIRCLE ONE)

 

DATE OF BIRTH__________    ___

                                             (MONTH/DAY/YEAR)

 

ADDRESS ____________________________________________________________________

 

CITY ________________________________STATE __________ZIP CODE _____________

 

HOME PHONE  (_____)_________________  ALT. PHONE   (______)_________________

 

FATHER’S NAME      __________________________________________________________

                                                                                          (LAST NAME)                                              (FIRST NAME)

MOTHER’S NAME    __________________________________________________________

                                                            (LAST NAME)                                        (FIRST NAME)

PLAYER’S POSITION__________________              SHOOTS :   RIGHT      LEFT

 

DOES PLAYER WISH TO BE A GOALIE?            YES  or  NO

                                                                                    CIRCLE ONE)

 

TEAM OR ASSOCIATION PLAYED FOR LAST SEASON_______________________________

 

 

*** Mite through Midget Players ***

 

All players from Mite through Midget.  Non-refundable regular registration fee of $125.00 per player/$250.00 per family must accompany this form. 

 

MAIL THE COMPLETED APPLICATION  AND

A COPY OF THE  PLAYER’S  BIRTH CERTIFICATE TO:

S.C.S.H.A. REGISTRAR

P.O. BOX  653

ST. CLAIR SHORES,  MI  48080-0653

 

 

THIS AREA FOR SCSHA LEAGUE USE ONLY

 

POSTMARK DATE________________________   DIVISION/AGE CLASSIFICATION__________________________

 

 

 

ALL PLAYER REGISTRATIONS WILL ONLY BE

ACCEPTED FROM THE S.C.S.H.A.  P.O.  BOX

 

 

 

 

PLAYER REGISTRATION MUST INCLUDE THE FOLLOWING OR WILL BE RETURNED:

 

1.)     COMPLETED REGISTRATION FORM

2.)     CORRECT REGISTRATION FEE CHECK OR MONEY ORDER MADE PAYABLE TO S.C.S.H.A.

 

MAIL COMPLETED REGISTRATION FORM AND PAYMENT TO:

S.C.S.H.A.

P.O. BOX  653

ST. CLAIR SHORES,  MI  48080-0653

 

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