2021/22 Player Registration Form (Listowel Minor Hockey Association)

Print 2021/22 Player Registration Form
Player Information
  1. RadDatePicker
    Open the calendar popup.
  2. This is the first payment price. Additional payments will be published at a later date.
  3. Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
    Maximum # Files: 1. Maximum File Size: 4MB.
    Only required for first time registrants to LMHA
Parent Information
  1. Example: [email protected] Your submission will be sent to this address.
  2. Example: ###-###-####
  3. Example: ###-###-####
Payment Method
  1. Website/Publications Consent

    As the parent/legal guardian of a player on a Listowel Minor Hockey Association (“LMHA”) team, I consent to the disclosure of personal information about my son/daughter on the applicable team by its posting on the website of LMHA (www.listowelminorhockey.ca) and by its publishing in any newsletters, yearbooks or other published material by Listowel Minor Hockey Association.  This consent only applies to the following:

    1.       Photographs of my son/daughter

    2.      Athletic result of my son/daughter

    3.      Awards, scholarships, prizes received by my son/daughter

    4.      Activities of my son/daughter as are related to his/her involvement with LMHA

    I am aware that by giving this consent, I am permitting personal information about my son/daughter to be published, which can be viewed by anyone who accesses the LMHA website or publications and that if consent were withheld, this posting and publication would not occur.


    Disclaimer:  Release of all responsibility in the event of an accident or illness to the participant while practicing, traveling to or from, or playing in a game is hereby given by the parent o r guardian whose name appears below.  The LMHA, PACC and all persons involved in carrying out the Minor Hockey Program are therefore not liable for any accident or illness that might occur.


    I further understand that this consent may be withdrawn by me at any time upon written notice.  I give this consent voluntarily.

    LMHA fully supports the guidelines & directives set under the OMHA’s abuse policy, as it relates to the players, coaches, officials & spectators.  Your signature acknowledges your support of LMHA’s efforts to follow and enforce this policy, when and if necessary, so that everyone may enjoy their hockey experience!

  2. Ontario Hockey Federation Rowan’s Law Acknowledgement Form

    The Ontario Government has enacted Rowan’s Law (Concussion Safety), 2018, S.O. 2018, c. 1 (“Act”). Ontario Regulation 161/19, the Act requires all sport organizations as defined in the Regulation (“Sports Organization”), which includes the Ontario Hockey Federation (“OHF”), to have a Concussion Code of Conduct. This Concussion Code of Conduct must require participants, as set out in the Act, to review the Ontario Government’s issued Concussion Awareness Resources on an annual basis. 

    A participant is subject to a Concussion Code of Conduct for each Sports Organization a participant registers with.

    The OHF Concussion Code of Conduct and the appropriate Concussion Awareness Resources must be reviewed before you can register/participate in the OHF.

    Review the OHF Concussion Code of Conduct here:  OHF Concussion Code of Conduct

    Review the Concussion Awareness Resources via these links:

    • 10 and Under Concussion Awareness Resource
    • 11-14 Concussion Awareness Resource
    • 15 and Over Concussion Awareness Resource

    If you would like to have a record of your review of the concussion awareness resources, you can complete this form and print a copy it as a receipt to remind you of the date on which you reviewed it.

    Acknowledgement of Review

Human Validation