/ Parkdale Flames Hockey Association
179 Brock Street, Toronto, Ontario M6K 2L7
www.parkdaleflames.com /

TOURNAMENT APPLICATION (2 pages total)

TOURNAMENT: PARKDALE FLAMES / WILLIAM REYNOLDS HOCKEY TOURNAMENT

LOCATION: 179 BROCK STREET TORONTO, ONTARIO

DATES: DECEMBER 5TH, 6TH, and DECEMBER 7TH, 2014

DAYS & TIMES: Friday 6PM – 10PM, Saturday 8AM – 8PM, Sunday 8AM – 3PM

TEAM:

CLUB NAME:
TEAM NAME:
SERIES:
(ATOM OR PEEWEE)

WE, THE UNDERSIGNED, UNDERSTAND THAT THIS FORM MUST BE COMPLETED AND REGISTERED WITH THE PARKDALE FLAMES HOCKEY ASSOCIATION OR PERMISSION MAY BE DENIED.

TEAM OFFICIAL, COACH OR TEAM MANAGER (CONTACT FOR TOURNAMENT)

NAME
ADDRESS
CITY / POSTAL CODE
RES. PHONE / EMAIL
BUS. PHONE / CELL (OTHER)

It is understood and agreed that the Parkdale Flames Hockey Association, its sponsors, directors, members and team officials assume no liability for injuries or other loss of any kind as a result of participation in, or traveling to and from the Parkdale Flames/William Reynolds Hockey Tournament. It is agreed that all players, team officials, and league representatives of the applicant abide by all tournament rules & regulations. The undersigned confirms that the application is part of an organization which is affiliated with the Canadian Hockey Association.

Signature: ______Date: ______

(Team Official)

Please send this completed application and roster sheet accompanied by cheque or money order in the amount of $550.00 payable to the “PARKDALE FLAMES”, A.S.A.P.

Mail your entry forms and cheque in the amount of $550.00 to:

Parkdale Flames/William Reynolds Hockey Tournament

C/O Brian Haggan - 242 Saint Clarens Avenue

Toronto, Ontario, M6H 3W3

Telephone: (416)-536-7320 or (416)-453-9698 (Tournament Co-Director)

Application and Roster Forms can be returned via email to

/ Parkdale Flames Hockey Association
179 Brock Street, Toronto, Ontario M6K 2L7
www.parkdaleflames.com /

PLEASE COMPLETE AND SEND ALONG WITH APPLICATION / PAYMENT

TEAM NAME ______

TEAM ROSTER – PLEASE COMPLETE IN FULL

JERSEY COLOUR______DIVISION: ______

Please print clearly

TEAM STAFF / TEAM ROSTER
Pos
/ jersey / Players Full Name (First, Last)
HEAD COACH: / G / # / NAME:
ASST. COACH: / G / # / NAME:
LD / # / NAME:
C / # / NAME:
RW / # / NAME:
LW / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:
ALT / # / NAME:

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