Vintage Hockey > Online Registration

Team Leader Details

First Name *:

Last Name *:

Password:

Confirm Password:

Email Address *:

Country *:

Region:

Address Line1:

Address Line 2:

City *:

Postal Code:

Telephone:

Team Details

Team Name *:

Team Address:

Web Site:

Estimated Team Numbers:

Players:

Supporters:

Team Entry Details:

Category *:

Mens
Mixed
Womens

Age Group *:

35-44
45 & Over

Number:

Names:

TEAM ACCOMMODATION

Please indicate your requirements and preferences below.

DIVI SOUTHWINDS HOTEL

Share Twin or Double Garden View Unit:

Share Twin or Double Ocean View Unit:

DOVER BEACH HOTEL

Share Twin or Double:

Triple:

Quad:

COCONUT BEACH HOTEL

Share Twin or Double:

Triple:

ROSTREVOR HOTEL

Share Twin or Double Standard Pool Unit:

Share Twin or Double Studio Ocean Unit:

Share Twin or Double Standard Ocean Unit:

Share Twin or Double One Bedroom Ocean View:

Share Twin or Double Two Bedroom Ocean View:

Share Triple Standard Ocean View:

Share Triple One Bedroom Ocean View:

Share Quad Two Bedroom Ocean View:

Preferred property (if any):

Registration Fee :

Entry Fee (payable upon entry): US$200
Bank Transfer
Cheque or Bank Draft
Credit Card (PayPal)

Terms and conditions *:

I have read and agreed on Terms & Conditions of entry