On-Ice Insurance Form (Orillia Minor Hockey Association)
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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
Telephone
Example: ###-###-####
Address
City
Postal Code
Coach Email
Example:
[email protected]
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