Byron Community Church

2025 Ball Hockey Registration

• • Child Name*
    First Name

    Last Name
  • Child's Date of Birth*
    MM

    DD

    YYYY
  • Child's Shirt Size*
    Please select a shirt size for your child.
    >Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult Large
  • Player's Interest in Playing Goalie*
    >UnknownNeverIf I have toSometimesFrequently
• • Parent/Guardian Email*
     
  • Address
    Street Address

    Address Line 2

    City

    Province / State / Region

    Postal Code / Zip

    Antigua and BarbudaBahamasBarbadosBelizeCanadaCosta RicaCubaDominicaDominican RepublicEl SalvadorGrenadaGuatemalaHaitiHondurasJamaicaMexicoNicaraguaPanamaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesTrinidad and TobagoUnited StatesArgentinaBoliviaBrazilChileColumbiaEcuadorGuyanaParaguayPeruSurinameUruguayVenezuelaAlbaniaAndorraArmeniaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBulgariaCroatiaCyprusCzech RepublicDenmarkEstoniaFinlandFranceGeorgiaGermanyGreeceHungaryIcelandIrelandItalyLatviaLiechtensteinLithuaniaLuxembourgMacedoniaMaltaMoldovaMonacoMontenegroNetherlandsNorwayPolandPortugalRomaniaSan MarinoSerbiaSlovakiaSloveniaSpainSwedenSwitzerlandUkraineUnited KingdomVatican CityAfghanistanBahrainBangladeshBhutanBrunei DarussalamMyanmarCambodiaChinaEast TimorIndiaIndonesiaIranIraqIsraelJapanJordanKazakhstanNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLebanonMalaysiaMaldivesMongoliaNepalOmanPakistanPhilippinesQatarRussiaSaudi ArabiaSingaporeSri LankaSyriaTaiwanTajikistanThailandTurkeyTurkmenistanUnited Arab EmiratesUzbekistanVietnamYemenAustraliaFijiKiribatiMarshall IslandsMicronesiaNauruNew ZealandPalauPapua New GuineaSamoaSolomon IslandsTongaTuvaluVanuatuAlgeriaAngolaBeninBotswanaBurkina FasoBurundiCameroonCape VerdeCentral African RepublicChadComorosCongoDjiboutiEgyptEquatorial GuineaEritreaEthiopiaGabonGambiaGhanaGuineaGuinea-BissauCôte d\'IvoireKenyaLesothoLiberiaLibyaMadagascarMalawiMaliMauritaniaMauritiusMoroccoMozambiqueNamibiaNigerNigeriaRwandaSao Tome and PrincipeSenegalSeychellesSierra LeoneSomaliaSouth AfricaSudanSwazilandTanzaniaTogoTunisiaUgandaZambiaZimbabwe

    Country
  • Phone Number*
     

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  • Child Health Card Number*
• Emergency Contact Information
  • Emergency Contact*
    First Name

    Last Name
  • Contact's Relationship to Child*
  • Emergency Contact Phone Number*
     

    (###)

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• IMPORTANT - Please Read
  • Does the child have any severe or life threatening allergies? Is there anything our volunteers should know such as any physical, emotional, or behavioral limitations in participating in the program?
• Precautions are taken for the safety and health of your child, but in the event of accident or sickness, Byron Community Church Inc, its staff, and its volunteers are hereby released from any liability. In the event that your child requires emergency treatment, you or your designated emergency contact will be notified immediately.
  • In case of surgical emergency, I hereby give permission to the physician selected by Byron Community Church Inc. to hospitalize, secure proper treatment for, and to order injection, anesthesia or surgery for my child as named above. *
    I agree.
  • The above named child is covered by Ontario health insurance (OHIP) or equivalent medical insurance.*
    I agree.
  • Do not bring valuables to the program. Byron Community Church and all its partners are not responsible for lost or damaged property.*
    I agree.
• Please note that e-mail is the primary mode of communication. By sharing your e-mail address you will receive important information as it relates to the ball hockey program, as well as occasional information regarding events and programs designed with our hockey players, and their families, in mind.
  • I hereby give Byron Community Church and all its partners, the absolute right and permission to publish/copyright/use pictures and/or video and/or audio in which I or my child may appear in whole or in part, composite or retouched in character or form. *
    I agree.
• • Our end of season awards presentation will include a guest speaker. Their presentation will include Biblical themes, scripture, and prayer.*
    I Understand
• • The season will include three Saturday morning drop-in practises. These practise sessions will include the sharing of Scripture and Biblical themes such as: Encouragement, Teamwork, Integrirty, etc.*
    I Understand
  • How did you hear about this program?*
    >Returning PlayerParticipated in other church programsOnlineFrom a friendOther
• 
  Submit