EAST GWILLIMBURY
DUNSMUIR MEMORIAL TOURNAMENT
April 9-12, 2015.
TEAM NAME: ______________________________________
ASSOCIATION: ______________________________________
ASSOCIATIONS WEBSITE: _____________________________________
AFFILICATION (OMHA, Alliance) ________________________________________
TEAM COLOURS: home: away: ______________________________________
TEAM CONTACT: ______________________________________
ADDRESS: ______________________________________
POSTAL CODE: ______________________________________
TEL (1): (2): ______________________________________
E-MAIL ADDRESS: ______________________________________
CATEGORY: _________________________________________________________
(e.g. Atom, Peewee, etc. Please indicate minor or major)
The entry fee/non refundable deposit (please circle) of $950 is enclosed and made payable to East Gwillimbury Minor Hockey Association (EGMHA). A representative from EGMHA will contact you by e-mail once the cheque has been received. Please ensure your e-mail address is correct.
Please send your application and payment to:
Dunsmuir Memorial Tournament
138 Mainprize Cres.
Mount Albert, ON
L0G 1M0
I (Team Manager) on behalf of my team, consent to participation in the EG Dunsmuir Memorial Hockey Tournament (EGDM) and assume all risks that are incidental to such participation. I therefore agree to waive indemnity & hold harmless (EGDM) and their employees, agents, servants and assigns. I certify that all players are in good physical and mental health and any exceptions have been noted by me with this application. I warrant that all of the players on my team have been given permission by their parents or legal guardian to participate in this tournament and that I am authorized to make this statement on their behalf. The Applicant acknowledges and agrees that (EGMHA) reserves the sole and exclusive right to use any photographs or videos taken during the program for advertising and/or instructional purposes contained herein. I acknowledge that the contact information provided above can be used for future correspondence related to tournaments and other hockey-related offers, but can unsubscribe at any future time. I acknowledge reading this Application and Declaration and understand the conditions herein and agree to abide by all terms.
SIGNATURE ________________________________ Date: ___________________________