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ONLINE REGISTRATION
Player Information
Parent/Guardian Information
Consent
Division
All fields are mandatory unless marked with an asterick (*)
Player First Name
Player Last Name
Player's Birth Date
Gender
Year
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Male
Female
Player Home Phone
For example
Player Cell Phone (*)
For example
Player email Address (*)
Street Number
Street Name
Unit/Apartment No (*)
Town
Select Town
Arden
BANCROFT
Belleville
Campbellford
Codrington
Corbyville
Eldorado
Flinton
Foxboro
Frankford
Hastings
Madoc
Marmora
Napanee
Parham
Plainfield
Port Hope
Quinte West
Roslin
Selwyn
Springbrook
Stirling
Thomasburg
Trenton
Tweed
My town is not listed
Town Name
Player have any medical conditions?
No
Yes
Medical Condition
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