Office Phone

250 992 2119
Email: qdmha@shaw.ca

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Hours

Mon, Wed, Thurs: 9 am–1 pm
Tues – 4 pm–8 pm
Closed all Stat Holidays

MINOR HOCKEY REGISTRATION FORM

You will need your HCR (Hockey Canada Registry) number in order to register.

If you are new to minor hockey, please fill out this form.

    Kids Sport and Jump Start are available to pay for sports fees, for families who qualify, so every kid can play. Please apply online.

    Please email the office (qdmha@shaw.ca) if you have any registration challenges.

    Player Name(Required)
    Gender
    MM slash DD slash YYYY
    Player Address(Required)

    Parent-Guardian Information

    Father's Contact Email(Required)
    Mother's Contact Email(Required)

    Payment Options

    E/TRANSFER TO qdmha@shaw.ca, please add on the Notes Section of your transfer the name of the player(s) you are paying for.

    WAIVER • RELEASE • MEDIA RELEASE

    WAIVER: We hereby acknowledge the authority of the NCD, BC HOCKEY and QDMHA and agree to carry out and abide by the Constitution, Bylaws, and rules and regulations of those associations.

    RELEASE: In consideration of this application to play under the auspices of QDMHA, I do hereby for myself, heirs, executors, administrators and assigns, remise, release and forever discharge the NCD, BC HOCKEY, QDMHA, its officers, or anyone acting on their behalf from all manner of litigation, damage, claims, or demands in law or equity which I may have or acquire by reason of person injury, loss or damage to property, which may occur during or by reason of participation in the activities of QDMHA.

    MEDIA RELEASE: BY REGISTERING AND ENTERING THE QUESNEL HOCKEY RINK(S) AND BY YOUR PRESENCE HERE, YOU CONSENT, AND GIVE CONSENT TO ANY MINORS WHOM YOU ARE RESPONSIBLE FOR TO BE PHOTOGRAPHED, FILMED AND/OR OTHERWISE RECORDED. YOUR ENTRY CONSTITUTES YOUR CONSENT TO SUCH PHOTOGRAPHY, FILMING AND/OR RECORDING AND TO ANY USE, IN ANY AND ALL MEDIA THROUGHOUT THE UNIVERSE IN PERPETUITY, OF YOUR APPEARANCE, VOICE AND NAME FOR ANY PURPOSE WHATSOEVER IN CONNECTION WITH THE PRODUCTION ENTITLED: QUESNEL MINOR HOCKEY LIVESTREAM. YOU UNDERSTAND THAT ALL PHOTOGRAPHY, FILMING AND/OR RECORDING WILL BE DONE IN RELIANCE ON THIS CONSENT GIVEN BY YOU BY ENTERING THIS AREA

    QDMHA will not give out personal email addresses, although other parents may see your email address.

    EQUIPMENT: We, at the end of each season covered by this registration, agree to return all equipment provided by QDMHA in good condition and should we fail to do so we agree to reimburse the QDMHA for the replacement of the same.

    REFUND POLICY: ALL REQUESTS FOR REFUNDS MUST BE MADE IN WRITING, REFUNDS WILL HAVE INSURANCE COSTS DEDUCTED. ANY REFUNDS AFTER OCTOBER 15TH WILL BE CHARGED A $30.00 ADMINISTRATION FEE.
    I agree to the above terms(Required)
    This field is for validation purposes and should be left unchanged.