London Ladies Classic Registration

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Division: *

Contact Information

Coach's Name: *

Email: *

Street Address: *

City: *

Province/State: *

Country: *

Postal/Zip Code: *

Phone:

Cell:

Work:

Years Coached:

Team Information

Team Name:

OWHA Team #:

USA Hockey Team #:

Record:

Individual OWHA Player Names & Numbers:

enter the players name followed by OWHA number followed by comma
eg. Jane Doe 54678,

Traveling Party

Coaches:

Players:

Boosters:

Cheerleaders:

ENTRY FEES - REDUCED PRICE!!!!
BEFORE JULY 1, 2011
Canadian Teams - $750.00 (Cdn - includes Gate Fee)
American Teams - $725.00 (US - includes Hockey Canada Fee & Gate Fee)
AFTER JULY 1, 2011
Canadian Teams - $825.00 (Cdn - includes Gate Fee)
American Teams - $800.00 (US - includes Hockey Canada Fee & Gate Fee)
BEFORE JUNE1, 2011? TAKE OFF A FURTHER $25.00!!!

Please forward this entry form and entry fee (payable to DEKE'S SPORT) to;
MIKE CHANEY/DEKE'S SPORT
23 COACHWOOD CR.
LONDON,ON.CANADA N6K-3C8
E-Mail - Mike.Chaney@sympatico.ca

London Ladies Classic Registration

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