Name:                                                                     

Male/Female:                                                            

Skill Level:    1    1.5    2    2.5     3     3.5     4     4.5     5   (1=Beginner)

Can you be a goalie for part of a Game?        Y / N   

Division:  Sunday Rec   Monday Rec   Tuesday Rec   Wednesday Rec   Thursday Rec

Phone:                                                                     

Email:                                                                     

Fee Enclosed: $                                                        

Spring /  Summer  /  Fall / Winter 1 / Winter 2 League

Make Cheques Payable to Perpetual Motion

- Individuals can register for $45*/person Spring, Summer and Fall league

- Individuals can register for $85*/person Winter 1 and Winter 2

(However, team placement is not guaranteed and subject to available space)

* = includes H.S.T.

 

 Please place me on the same team as my friend(s) listed below (only one form is necessary for a small group):

Name	Phone Number	Email	M/F
1)
2)
3)
4)
5)