Registration Form August 5 & 6, 2017. Halifax Nova Scotia Canada



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Atlantic Cup 2017

Team Registration Form

August 5 & 6, 2017. Halifax Nova Scotia Canada

Team Name:







Team Manager:







Address:







City:




Postal Code:




Telephone: (H)




(W)




(C)




Email:




Fax:




Uniform / Sock Color:




/




Players: (Maximum 18 Players)

1.




10.




2.




11.




3.




12.




4.




13.




5.




14.




6.




15.




7.




16.




8.




17.




9.




18.






Division: Open




Junior







Fees: $700 CAD

Late Fee: $50


Cheque payable to: Field Hockey Nova Scotia Due by: July 14th, 2017.

Signature:






Please send to:

Lori Ann Andrews

37 Scotch Pine Terrace

Halifax Nova Scotia

B3S 1E2


(H) 902-479-0563 (W) 902-496-5861

Email: mlsandrews@bellaliant.net



PLEASE NOTE: Once registration has been received, teams will be subjected to a $100.00 non-refundable administration fee should they cancel their attendance before July 14/17. Registration fees cannot be refunded to teams cancelling after July 14, 2017.

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