2023.24 Players Registration Form Registration Form Please submit player registration no later than September 1, including all applicable fees. Back to Welcome Page Please enable JavaScript in your browser to complete this form.Player Profile - Step 1 of 62023.24 Player ProfileFirst Name *Last Name *Player Email *Player Cell *Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Height (ft/in) *Weight (lbs) *NextPlayer ApparelT-Shirt SizeSelect SizeMLXLXXLHoodie SizeSelect SizeMLXLXXLTrack Pant SizeSelect SizeMLXLXXLPreviousNextFamily Information (Your POD)Home Address *Address Line 1CityState / Province / RegionPostal CodePlease fill out the primary residence of the player for the upcoming season.Mother's Name *FirstLastMother's Email *Father's Name *FirstLastFather's Email *PreviousNextPlayer Medical InformationBC Care Card or Health Insurance No. *Medical ConcernsEmergency ContactName *FirstLastPhone *Email *Parent/Guardian Consent *When checked, Parent/Guardian gives full consentI 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 (Only if different than above)FirstLastParent/Guardian PhoneParent/Guardian EmailPreviousNextPayment Plan OptionsChose PlanFull Amount $8,200 (includes PJHL League Fee)Payment Plan | $4,200 Sept. 1 (includes PJHL League Fee) | 2,000 Oct. 6 | 2,000 Nov. 10Indicate Payment MethodCheque(s) | Made payable to White Rock WhalersE-Transfer | Sent to pay@whiterockwhalers.ca (Note: The player's full name must be in the message notes)PreviousNextUpdating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit Now Back to Welcome Page
