First Name

Last Name

   mm / dd / yy             Age

City                                                  Postal Code
Home Phone             Work / Cell           Extension
Did you play Minor Hockey ? YES NO
Did You Play High School Hockey ? YES NO
Did You Play Industrial Hockey ? YES NO
Did You Play O.H.A. or Higher ? YES NO
Have You Ever Played Non Contact ? YES NO

Check off the skill level you feel you may be in this league.

A - above average B - average C - fair D - inexperienced

Which position would you like to play ? ---  Check only one.

Center Right Wing Left Wing Left Defense Right Defense Goalie

You can pay all at once or send $120.00 with the application by August 1st, plus
two post dated checks for September 1st and October 1st at $120.00 each.

This is a new league with limited resources at this time therefore,
we do not have a refund policy.
You may find a player willing to take your place upon league approval.


I wish to participate in the activities of the Original Six Hockey League and hereby assume all risks and hazards incidental to such participation including transportation to and from these activities.
I also agree to participate within the rules and bylaws of the Original Six Hockey League.
I therefore do hereby waive, release, absolve and agree to hold harmless the Original Six Hockey League, its sponsors, executive, participants, officials and any persons transporting me to or from any activities, of any claim arising out of injury, loss or damage to me.

Yes I Accept              Signature

After filling out the on-line form you can copy and paste it into an e-mail to CONTACT- 905 574-1125.