K-W Oldtimers Hockey League, Winter 2025-2026

Registration of New Member

Step 1 of 5  - Personal Information

Please tell us your name, address, and contact information.

First Name*

Last Name*

Home Address*

Birth Date*

Suite/Unit/RR#

Email Address*

City*

Home Tel

Province*

Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon

Mobile Tel

Postal Code*

First Aid Certified?*

No

Yes

Are you First Aid/CPR-AED certified by Red Cross or St. John Ambulance?

In case of an on ice emergency, who should be contacted?

Contact Name*

Home Tel

Mobile Tel