Team Application Form (2003-04)

Hockey Association

 Assoc Size ( Circle one - reference chart )

( Small )       ( Medium )       ( Large )
Age Classification    (Circle one)

( Mite )    ( Squirt )    ( PeeWee )    ( Bantam )    ( Midget 16U )    ( Midget 17U )
 Level of Play    ( Circle one )

( B )        ( A )        ( AA )
Team Name

 Selection Order    ( Circle one - reference chart )

( 1st )   ( 2nd )   ( 3rd )   ( 4th )   ( 5+ )   ( Single )   ( House )

Head Coach Assistant Coach Manager/Scheduler
Name:

Address:

City:
____________________

____________________
____________________

____________________
____________________

____________________
Phone:
   Home - ________________

   Work - ________________

   Fax -
   Home - ________________

   Work - ________________

   Fax -
   Home - ________________

   Work - ________________

   Fax -
E-mail:


* Level of Play classification as determined by the 2003-04 Rules and Regulations. Team should identify their level of play based on the Team Placement Chart. The BTHL reserves the right to re-classify and/or refuse to admit teams in the event that inaccurate information is provided on the application. The goal of league play is to provide the opportunity for all teams to be competitive within their classification. All applications should include a roster including birth dates. Applications for the "B" division must include past level of play for all players if the team does not meet the requirements as defined on the chart. Please note there will be no exceptions considered for the "A" and "AA" divisions. As identified in the Rules & Regulations, the team roster must be approved and on file with BTHL before League play.

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:

Payment: Team Fee $525 (On time) (postmarked by August 30, 2003)**

Includes $125 registration and $400 tournament fee for end-of-season play-offs

Late Fee $50/team (Total due $575) (MUST BE RECEIVED by September 6, 2003)***

Note that this deadline is NOT a "postmark" deadline, the application must be in our hands.

Please return this and Roster to:
(Make check payable to
"Buckeye Travel Hockey League") 		Buckeye Travel Hockey League
c/o Len Holtgreven
1707 Cherry Ln.
Findlay, OH 45840 		IMPORTANT:
For Association's mailing one check;
please complete a form for each team.

For additional information concerning teams and levels of play, contact
Len Holtgreven @ 419/422-3433-Home or 419/422-4779-Work or LenHoltgreven@loadmasterscale.com