First name

Last name

Pronouns

Email

Emergency Contact name and number

Are you "out" to your emergency contact? If not, please specify what name/pronouns to use in case of emergency.

Please note any medical conditions you believe we should be aware of in event of an emergency. This information will be kept confidential.

Do you consent to your name and/or photo being used in media?

Yes to both

No to both

Name only

Photo only

Confirmation

I understand I must provide payment to secure my spot. The payment window will appear once I click submit.

I understand I must sign Ottawa Pride Hockey's Waiver and Code of Conduct to participate in OPH activities. Please sign if you have not already.

Beginner Skills Registration