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) are required.
Please note, all fields with an asterisk (
*
) are required.
League Or Tournament:
*
League
Tournament
League Name:
*
Contact:
*
Address:
City:
*
Province/State:
*
<Select province/state >
AB Alberta
BC British Columbia
MB Manitoba
NB New Brunswick
NL Newfoundland
NS Nova Scotia
NT Northwest Territories
NU Nunavut
ON Ontario
PE Prince Edward Island
QC Québec
SK Saskatchewan
YT Yukon Territory
AK Alaska
AL Alabama
AR Arkansas
AZ Arizona
CA California
CO Colorado
CT Connecticut
DC District of Columbia
DE Delaware
FL Florida
GA Georgia
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IA Iowa
ID Idaho
IL Illinois
IN Indiana
KS Kansas
KY Kentucky
LA Louisiana
MA Massachusetts
MD Maryland
ME Maine
MI Michigan
MN Minnesota
MO Missouri
MS Mississippi
MT Montana
NC North Carolina
ND North Dakota
NE Nebraska
NH New Hampshire
NJ New Jersey
NM New Mexico
NV Nevada
NY New York
OH Ohio
OK Oklahoma
OR Oregon
PA Pennsylvania
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VA Virginia
VT Vermont
WA Washington
WI Wisconsin
WV West Virginia
WY Wyoming
Country:
*
<Select country >
other
Canada
United States of America
Postal code:
Phone:
*
(999-999-9999)
Fax:
(999-999-9999)
Web Site:
E-mail:
*
Insured?
Sport:
*
<Select sport >
Ball Hockey
Basketball
Curling
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Football
Hockey
Lacrosse
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Slo Pitch
Soccer
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Type:
<Select type >
Boys and Girls
Boys
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Ladies (age of majority)
Master
Mens (age of majority)
Mixed (age of majority)
Notes:
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