2022.23 Players Registration Form

Step 1 of 2

2022.23 Player Profile

Player Name *

First

Last

Player Email *

Player Cell *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Date of Birth *//

Height (ft/in) *

Weight (lbs) *

Mother's Name *

First

Last

Mother's Email *

Father's Name *

First

Last

Father's Email *

Player Apparel

T-Shirt Size

Hoodie Size

Track Pant Size

Player Medical Information

BC Care Card or Health Insurance No. *

Medical Concerns

Emergency Contact

Name *

First

Last

Phone *

Email *

Parent/Guardian Consent *

When checked, Parent/Guardian gives full consent

I do hereby consent to said player participating in all activities at the White Rock Whalers 2022-2023 Season, and do hereby release, absolve, indemnify and save harmless the White Rock Whalers Junior Hockey Club and the Pacific Junior Hockey League, and both organization’s employees, officers, coaching staff, management and/or volunteers, from any claim(s) which may arise as a result of his/her participation. I assume all risks and hazards incidental to the above article and do hereby waive all claims whatsoever which I or the above named player may have against the White Rock Whalers Jr B Hockey Club and/or the Pacific Junior Hockey League.

Parent/Guardian Name *

First

Last

Parent/Guardian Phone *

Parent/Guardian Email *

Payment Plan Options

Chose Plan *

Full Amount $7,200 (includes PJHL League Fee)
Payment Plan | $3,200 Sept. 11 (includes PJHL League Fee) | 2,000 Oct. 15 | 2,000 Nov. 15

Indicate Payment Method *

Cheque(s) | Made payable to White Rock Whalers
E-Transfer | Sent to pay@whiterockwhalers.ca (Note: The player's full name must be in the message notes)

Registration Form

Please submit player registration no later than September 11, including all applicable fees.

2022.23 Player Profile

Player Apparel

Player Medical Information

Emergency Contact

Payment Plan Options