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NASHA Membership Application
1. Please complete this form for EACH team in your association
2. Complete a NASHA insurance roster for EACH team
Team Name:
Season Dates:
Start:
End:
Team Contact
Name:
Address:
Postal Code:
Telephone:
E-Mail:
Date:
Signature:
Team Information
Age Group (Tyke, Novice etc):
# of Tournaments Planned:
# of Practics Planned:
# of Exhibition Games Planned:
Game Types:
Contact
Non-Contact
# of Tournaments Outside Canada:
If playing outside Canada, please provide details below:
Team Roster Table
#
Last Name
First Name
Sex
Birthday
(d/m/year)
Address
Postal
Code
Phone
Number
E-Mail
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Last modified Monday, June 27, 2011
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