On-Ice Insurance Form (Orillia Minor Hockey Association)

Print On-Ice Insurance Form

For those individuals who will be helping on ice during practices with a team. Only individuals with certification (coach/trainer/asst coach etc) can be on the bench during a game.

Team
Last Name
First Name

Date Of Birth

Open the calendar popup.

Telephone

Example: ###-###-####
Address
City
Postal Code
Coach Email

Example: [email protected]

Human Validation

Check The Box ^*

On-Ice Insurance Form (Orillia Minor Hockey Association)

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