Hockey for Haxton

HOCKEY FOR HAXTON & EASTER SEALS BENEFIT TOURNAMENT

Team Registration Form

Fund Raiser Event will be Saturday, December 17, 2016 (U12,U14,U16,U19)

At Milton Elementary School

and

Sunday, December 18, 2016 (ADULTS, possibly one pool of U19))

At Milton Elementary School

Each team will play four 20-minute games unless the team registers for a second time slot (at an additional team cost). 6v6 using FIH indoor rules. There may be two male team members on the floor at one time (GK is non-gendered)

Team name (REQUIRED and uniform color):

Team age group (circle one): Adult U19 U16 U14 U12

Team Classification (circle one): Club or Social

Player names: (minimum of six, maximum of 9), birth date, T-shirt Size (adult sizing only)

Once the roster is submitted it is locked and teams cannot switch members, since the skill level of the roster members determines the pools. It is a fun event but Delaware Shore tries to match teams by skill level so all will have an enjoyable event.

If a team will not have a goalkeeper, they may arrange for a GK during their pool play. Rent-a-Keeper fee is $25 and you have the same keeper for all the games in your pool.

ENTRY FORM, ROSTER, WAVIER AND REGISTRATION FEE IS DUE BY THE DEADLINE. FAILURE TO SUBMIT ALL OF THE ABOVE MEANS YOUR TEAM WILL NOT BE INCLUDED IN THE BENEFIT.

Name (last,first) DOB(mm,dd,yy) T-shirt (S,M,L,XL)

TEAM NAME: PRIMARY SHIRT COLOR:

Principal Team Contact (REQUIRED WITH Name, phone number and email):

Alternate Team Contact (REQUIRED with authority to make decisions in the event the principal contact is unavailable: Name, Phone number and email):

Cost per team:

$200 Team Check (NO individual athlete checks PLEASE) if received by the deadline.

$210 If paying by Credit Card on the Delaware Shore H4H 2015 webpage.

Make check payable to DSFH, Inc.Send all forms and one check(we are only excepting one check per team) to:

Danielle Renken

Hockey for Haxton Event Coordinator

25 Tiffany Drive

Rehoboth Beach, DE 19971

Registration and check are due by December 1, 2015.This is first come first serve and a spots are limited so please don’t delay. No team will be accepted without all forms and payment complete. If you have any questions you can e-mail or call Danielle Renken at or 302-841-5742.

Important Note for the Team Manager:

#1, all fees and the registration forms MUST be submitted by the deadline date. Failure to complete this requirement will result in the team(s) not being scheduled to play.

#2, in event of postponement or cancellation of the tourney due to unforeseen events or conditions, all fees will be considered a donation to the Haxton Scholarship and Easter Seals Rehabilitation Center.

#3, if a team does not show and participate in the tourney as scheduled, the fee will be considered a donation to the Haxton Scholarship and Easter Seals Rehabilitation Center.

#4, Please note that this is a FUN tourney and played with the memory of Amanda Haxton in mind. Sportsmanship is very important to us. We ask that everyone attending, participating and volunteering enjoy him or herself but be respectful and keep sportsmanship in mind. Please respect the umpires, volunteers and other participants.