Team Application Form (2010-11)

Hockey Association

Age Classification    (Circle one)

( Mite )    ( Squirt )    ( PeeWee )    ( Bantam )    ( Midget16 )    ( Midget18 )
 Level of Play    ( Circle one )

( A2 )       ( A1 )       ( A )       ( AA )
Team Name

 Relative Strength (est.) within Level of Play ( Circle one )

( High )         ( Medium )         ( Low )

Head Coach Assistant Coach Manager/Scheduler
Name:

Address:

City:
____________________

____________________
____________________

____________________
____________________

____________________
Phone:
   Home - ________________

   Work - ________________

   Cell -
   Home - ________________

   Work - ________________

   Cell -
   Home - ________________

   Work - ________________

   Cell -
E-mail:


* Level of Play classification will be determined by the Pre-season tournament (except Midget). Teams will initially be placed where the team applies combined with the estimated team strength and any other factors considered significant. A petitioning process will be used for teams that feel they've been inappropriately placed. All applications should include a roster with birth dates.

By signing this application form, the team contact person, on behalf of his/her team, releases the sponsors, organizers, officials, and volunteers of the Buckeye Travel Hockey League (BTHL) from any liability, injury or accident which may be incurred by any player, team official or spectator while participating in or traveling to or from League games and/or other League sponsored events.

Teams further agree to comply with all BTHL Rules and Regulations including the participation in an end-of-season tournament.

Signed:
Date:

Team Fee (On time):    $830-Squirt
$850-PeeWee $915-Bantam $750-Midget
Late Fee: Add $50 penalty per team
To be considered "on time" an application must be
POSTMARKED by Aug 14, 2010 		We will accept "late" applications up until Aug 21, 2010.
Please note this deadline is not a "postmark" deadline,
it MUST BE RECEIVED AND IN OUR HANDS by this date.

The fee includes everything; Pre-season tourn (except Midget),
Reg-season registration and Post-season tourn. 		Make checks payable to
Buckeye Travel Hockey League

Please return this and Roster to:

BTHL Team Application
c/o John Doyle
6439 Kincaid Road
Cincinnati, OH 45213

Phone: 513-631-6243 email: jtdoyle@cinci.rr.com 		IMPORTANT:
    For Association's mailing one check;
    please complete a form for each team.

For additional information concerning teams and levels of play, contact
Doug Burgdorf @ dburgdorf@cinci.rr.com