U18 Rep Registration

This form is acknowledging that you agree to represent North Harbour Hockey (NHHA) for the team you have been selected in. This agreement sets out the obligations of the players in respect of the Representative Hockey season.

Player First Name *

Player Last Name *

Players Email *

Player Agreement *

Covid-19 Player Policy *

Team *

Player Date Of Birth

Player Mobile Number *

Email for Invoicing *

Bank Acct Name *

Should there be a refund for the Rep Campaign please provide us with a bank account name

Bank Acct number

Should there be a refund for the Rep Campaign please provide us with a bank account name

Emergency Contact First Name *

Emergency Contact Phone Number *

Emergency Contact Last Name *

Relationship *

Medical Assistance Agreement *

Parent/Guardian Agreement *

Player Signature *

Parent/Guardian Signature *

U18 Rep Registration

Need help? Contact our team for more information on (09) 972-0613 or

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