Clone of 2025 13-18U Club Registration

Athlete's Name:

First NameLast Name

Date of Birth:

MonthDayYear

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name

First NameLast Name

Parent E-mail:

example@example.com

Additional E-Mail:

Cell Phone #

Format: (000) 000-0000.

Home Number

Format: (000) 000-0000.

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Format: (000) 000-0000.

Alternate Phone Number

Format: (000) 000-0000.

In the normal course of business and for the purpose of advertising, Memorial University may photograph or video participants as they partake in Memorial University programs and activities. Such photographs or video may be used by Memorial for publicity purposes without the child’s name attached, unless a parent/guardian otherwise advises Memorial in writing. Do you agree with this?

Please make sure you select the correct team:

13U Seahawks

Coached by Erin Grabka, Ally Hudder and Teagan Penner

$200.00 CAD

14U Red Seahawks

Coached by Juvy Donahue, Georgia Cartwright, and Beatrix Webb

$200.00 CAD

15U Red Seahawks

Coached by Lydia Grawer, Karen Greek, and Liz Lodge

$200.00 CAD

16U Seahawks

Coached by Sydney Rohm, Nella Woelfel and Keira Power

$200.00 CAD

17U Seahawks

Coached by Karen Murphy, Taylar Johnston and Ryan Keats

$200.00 CAD

18U Seahawks

Coached by Nick Higgins, Courtney Hodder and Ashlynn Harris

$200.00 CAD

Subtotal

Tax

Total

Credit Card (VISA or Mastercard only, cannot accept AMEX or Visa Debit)
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

13-18U Registration

Athlete Information

Please make sure you select the correct team:

13-18U Registration

Athlete Information

Please make sure you select the correct team:*

Please make sure you select the correct team: