Team Name*:

City: Prov./State:

Please check the category that your team is entering:

Pee Wee AA

Bantam AA

Female Bantam AA

 

Jersey Colors:

Home: Away:

Team Officials:

Manager*:

Address: City:

Prov./State: PC/Zip:

Phone: Fax:

Email*:

Coach:

Asst Coach:

Asst Coach:

Please Note: This tournament is sanctioned by the Winnipeg Minor Hockey Association and Hockey Manitoba, therefore all teams and players must be registered with the Governing Hockey Associations. A team roster must be forwarded with this application signed by your association. The Tournament Committee reserves the right to accept or reject entries. AA Teams will be allowed 15 skaters and 2 goaltenders. Cheques to be made payable to the Billy Mosienko Tournament, and must accompany the roster and this application. All official association rosters must be received by the Tournament Committee no later than November 25, 2010.

All teams and players must comply with the Hockey Manitoba Tournament Regulations. Travel permits are required for all out of town teams. Team line-ups submitted to the Tournament Registrar on player roster forms, are to be considered as the final line-up. No additions will be accepted, unless approved by the Tournament Committee. All applications must be received by the Tournament Committee no later than November 14th, 2010.

Signature*: Coach/Mgr Date:

You may submit this application electronically. You will be asked to fill in your team roster on the next screen.

2010 entry fees are $900 for AA/Bantam/Pee Wee teams. Please make cheques payable to "Billy Mosienko Hockey Tournament". Please mail to 19-1860 Burrows Ave, Winnipeg, MB R2X 0T2.

NO GATE CHARGES - ENTRANCE TO ALL GAMES FREE

For any other questions or confirmation of your entry, please Contact Don Brown (204) 632-0616.