Withdrawal Form - Glenlake Hockey Club

Withdraw Request

Name *

Email Address *

Player Hockey Canada ID number *This number was required to register your player. Please visit our website to learn how to find this number

Player First Name *

Player Last Name *

Birthdate of Withdrawing Player *

Month

Day

Year

Which is age group is your player registered for? *

Reason for Withdrawal? *

Name of the parent/guardian requesting the withdrawal *

Email of the parent/guardian requesting the withdrawal *

Relationship to withdrawing player *