AHG 3 vs 3 hockey
SUPERIOR PROPANE CENTER, MONCTON N.B.
DECEMBER 27 & 28, 2015
Registration Form
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Please indicate below team & coach
Team Name: ______________________________________________
Coaches name: ________________________________________________
Coaches contact number : ________________________________________
Email : _______________________________________________________
DIVISION : ___________________________________________________
LEVEL : ______________________________________________________
Please make cheque payable to: Atlantic Hockey Group
VISA: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Master Card: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
AMEX: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
Expiry Date: ____ / ____
Cardholder name: ___________________________________ (please print)
Cardholder signature: ___________________________________
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Registration Fee: $450.00
fax # 506.854.8200
Atlantic Hockey Group
12 Fifth street
Moncton, NB E1E 3G9
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