SUBSCRIPTION FORM  for 2012
   rocketaaa@videotron.ca

 

ROCKETS RIVE-NORD

2960 rue des  Hirondelle

Terrebonne, Qc

7M 1K6  

 

FOR INFORMATION please contact Frederick at  514-566-5741

 

 Printable PDF format click here

 

 

Subscription limit date: March 23, 2012

Between 12 and 15 teams by category will be accepted.

Please send the application form with a postated check or money order to:

LES ROCKETS DE RIVE-NORD
2960 rue des Hirondelles
Terrebonne,, Qc.
J7M 1K6

Team name : ______________________________
City : ____________________________________
Manager: ____________________________
Adress: _________________________________________________
Phone number: (___) ____________ Cell: (___) ____________
Email: ________________________

Coach: _________________________________
Adress: _________________________________________________
Phone number: (___) ____________ Cell: (___) ____________
Email: ________________________

Jersey colors: Room: _____________Visitor: _____________

Categories: 2005 - 04 - 03 - 02 - 01 - 00 - 99 - 98 (Please circle year.)

Pool AAA  (  )          Pool Challenge  (  )    check the Pool of your choice

   Team will be confirmed only once the cheque is received.

For more information, contact:
Luc Monastesse
Phone: 514-809-6226
Email: rocketaaa@videotron.ca