Panthers On The Prowl Girls Hockey Tournament

Please complete the online registration form. Payment must be mailed to address below. Please make all cheques payable to St.Thomas Panthers Girls Hockey Association. Upon receipt of payment, confirmation will be emailed to the Team Contact. Tournament registration is not confirmed untill payment has been received.

Tournament Dates: December 4 - 6, 2009
Entry Fee

$825.00 for Novice, Atom, Pee Wee, & Bantam
$950.00 for Midget & Senior

St.Thomas Panthers Girls Hockey Association,
PO Box 22049,
Elmwood Square,
St. Thomas, ON N5R 6A1

If you have any questions, please contact: Shirley Simpson: s.simpson@sympatico.ca

Contact Information

Name: *

Title:

Street Address: *

City: *

Province/State: *

Country: *

Postal/Zip Code: *

Phone: *

Cell:

Business Phone:

Email: *

Head Coach Name:

Head Coach Cell :

Team Information

Team Name: *

Division: *

Level: *

OWHA Team Number: *

Home Light Colour :

Home Trim Colour:

Away Dark Colour:

Away Trim Colour:

Bench Staff: Please enter your full name in the following format "First Name Last Name"

Bench Staff

Name: *

Title:

Certification Number: *

Bench Staff 2

Name:

Title:

Certification Number:

Bench Staff 3

Name:

Title:

Certification Number:

Bench Staff 4

Name:

Title:

Certification Number:

Bench Staff 5

Name:

Title:

Certification Number:

Please ensure accuracy as this information will be reproduced on all tournament documentation. Please enter your full name in the following format "First Name Last Name"

Player 1

Name:

Jersey Number:

Player 2

Name:

Jersey Number:

Player 3

Name:

Jersey Number:

Player 4

Name:

Jersey Number:

Player 5

Name:

Jersey Number:

Player 6

Name:

Jersey Number:

Player 7

Name:

Jersey Number:

Player 8

Name:

Jersey Number:

Player 9

Name:

Jersey Number:

Player 10

Name:

Jersey Number:

Player 11

Name:

Jersey Number:

Player 12

Name:

Jersey Number:

Player 13

Name:

Jersey Number:

Player 14

Name:

Jersey Number:

Player 15

Name:

Jersey Number:

Player 16

Name:

Jersey Number:

Player 17

Name:

Jersey Number:

Player 18

Name:

Jersey Number:

Player 19

Name:

Jersey Number:

Player 20

Name:

Jersey Number:

Panthers On The Prowl Girls Hockey Tournament

Bench Staff: Please enter your full name in the following format "First Name Last Name"

Please ensure accuracy as this information will be reproduced on all tournament documentation. Please enter your full name in the following format "First Name Last Name"

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