Attached is a registration form for rural community youth and coaches if they do not have a Minor Hockey Association in their Community that is an affiliate member of the British Columbia Hockey (BCAHA) or Canadian Hockey Association (CHA).

All Hockey players to be eligible for and compete in the following events must be insured and members of the BC Hockey:

  • CHA sanctioned events;
  • Canada Winter Games trails, ID Camps, practices and games;
  • Arctic Winter Games trials, ID Camps, practices and games;
  • Yukon Championships;
  • National Aboriginal Hockey Championships trials, practices and games;
  • Yukon Indian Hockey Association Youth and Jamboree Tournament
  • Other hockey related activities.

Note:

  • This registration process is for communities that do not have a Minor Hockey Association that is associated with BC Hockey or CHA. Dawson City, Watson Lake, Haines Junction, Teslin and Whitehorse all have Minor Hockey Associations that are affiliated with BC Hockey and CHA. Youth and Coaches in these communities must register through their respective associations, this form does not replace that process it’s just a membership and insurance process for communities that do not have the ability to register their own youth.
  • This insurance and membership is needed for participation in Canada Winter Games Trails/ID Camps, Games and Practices; Arctic Winter Games Trials/ID Camps, Games and Practices; Yukon Championships, the National Aboriginal Hockey Championships, trials and practices; Yukon Indian Hockey Associations’ Youth Tournament and other hockey related activities.

Fee:

  • The cost to register through the YASC Hockey Association is $50.00. This includes the BC Hockey insurance and membership fee and YASC administrative fee.
  • This fee does not include the cost of playing minor hockey in your community, trial fees, etc. Youth will still have to pay the communities regular hockey fees and also register in your community if there is a process to do this.
  • Registration Form and Fee must be handed in before any youth steps on the ice for any of the above events.

Coaches:

  • All coaches must have their Speak Out or Respect in Sport certificate to be insured. The Respect in Sport courseis offered free of charge through Yukon Government at (see Respect in Sport instructions)

* Required field to be insured!

Member’s Profile:

*Player’s/Coaches Name:______

*Address: ______

*City/Town: ______Postal Code:______

*Phone or Contact Number: ______

Aboriginal Ancestry (not required to fill out): Yes______No______

*Age as of Dec. 31, 2013______*Birth Date: ______

(Day/Month/Year)

*Gender: Male:______Female: ______Division: ______

Position:______MHA 2012/2013: ______

Goalie: Full Time: ______Part – Time: ______

Do you have your own Goalie Equipment?: Yes: _____ No: _____

Parent/Guardian Information (Please list ALL Parent/Guardian Names!)

Parent/Guardian (s) :______Relation:______

______Relation:______

Address: ______

Phone (h): ______Phone (w):______Phone (cell): ______

Email: ______


Player’s/Coaches Name:______

Medical Information

Please list any medical concerns that the player has (i.e. allergies, medical conditions, previous injuries, etc.): ______

*Health Care Insurance #: ______Province/Territory Issued______

Emergency Contact: ______Emergency Phone #: ______

Parent/Guardian’s Signature: ______

Payment Method by: Cash or Cheques ONLY

Please make Cheques payable to: Yukon Aboriginal Sport Circle

Individual Cheque

Cheque #: ______

Community Minor Hockey Association or Community Recreation Association Cheque

Cheque #: ______

Please send completed form to the following email or fax to:

Attention:Cindy Underhill - Youth and Jamboree Native Hockey Tournament Coordinator

Email:

Fax: 867-456-7290