Sex
Parent/Guardian Information
Email addresses will be added to the Mississauga Crusaders mailing list and as such will be available to coaches and other parents.
Player Type
Medical Information
Any information provided below will be treated with the strictest confidentiality. Should any information be passed beyond the directors, manager and coaches, permission will be sought from the guardian or parent prior to releasing among team officials.
Mississauga Crusaders Special Hockey Club will not assume any financial or legal responsibility for the health care of the athlete.
How does the medical diagnosis affect the athlete
Medical Precautions (seizures, respiratory, medications etc.)
Any recent injuries, operations or issues we should know about?
Hockey Experience
What are your expectations from the program?
Preferred Hockey Position
New Players ONLY - Jersey Number Preference (list 3 choices by priority)
Returning Players - Do you require a new jersey set? New jerseys will only be supplied if the player as outgrown their current jersey.
Sizing (Please list current jersey size and new size required)
Volunteering:
Volunteers are a necessary and valued part of our hockey club. Please indicate where as a parent or guardian or family/friend you could assist the Mississauga Crusaders Special Hockey Club.
Volunteering Preference #1
Volunteering Preference #2
Qualified Disclaimer
Parents or Guardians of participants are asked to carefully read and acknowledge the following information. This page must be agreed to prior to participation in the program. "Mississauga Crusaders Special Hockey Club" refers to the organization, its directors, agents, instructors and volunteers.
*You agree that the Mississauga Crusaders Special Hockey Club is not responsible for any bodily injury, loss, or damage to personal property suffered by the participant before, during or after the program.
*Mississauga Crusaders Special Hockey Club is dedicated to making sure that all players have fun. The volunteers on the ice are not professionals and have no special medical training.
*You agree that in the event of emergency medical attention or emergency evacuation, you will not hold the Mississauga Crusaders Special Hockey Club responsible for any costs arising out of any emergency situation.
*You agree that intentional participant behaviour that puts them or others at physical or emotional risk will result in immediate suspension and possible dismissal from the program at the discretion of the Mississauga Crusaders Special Hockey Club directors.
Name of Parent or Guardian (by typing your name below you agree to all the terms and conditions for your player to play for the Mississauga Crusaders Special Hockey Club
Mississauga Crusaders Special Hockey Club 2024-2025 Season Liability Waiver
I hereby give my consent for the above-mentioned player to play hockey under the auspices of the Mississauga Crusaders Special Hockey Club hereafter referred to as the M.C.S.H.C. and abide by the rules of the M.C.S.H.C. I hereby acknowledge that the M.C.S.H.C. does insure players, coaching staff, on-ice volunteers and directors and that I am responsible for any additional medical, dental or similar expenses that may be incurred as a result of any accident that may occur to the above mentioned player.
I agree that I shall provide health insurance to cover any personal injury and property damage sustained by the above-noted player while participating in any activities of the M.C.S.H.C., the undersigned assumes all responsibility for any and all risk of damage, loss or injury (including personal injury, illness or death) that may occur to the above mentioned player as a participant in any programs by M.C.S.H.C. including practices, scrimmages, skills sessions, games, transportation and other activities related to the program, including where such damage, loss or injury arises directly or indirectly out of a public health emergency including COVID-19 and any recurrences thereof. In consideration of such, the undersigned hereby releases and discharges the program, M.C.S.H.C., its operators, agents, coaches, instructors, volunteers, directors and other players from all claims, demands, actions, damages, injuries, liabilities, costs, expenses (including reasonable legal fees), rights, or causes of action present or future, whether known or anticipated and resulting from or arising out of an incident to the above-noted player's participation in said program, including without liability as described in this liability waiver. This shall also serve as my permission to have M.C.S.H.C. personnel act as our agent to engage such medical and dental treatment and hospitalization as may be reasonably required in event of illness or injury arising during or as a result of participation in the said program.
Name of Parent or Guardian (by typing your name below you agree to the Mississauga Crusaders Special Hockey Club 2024-2025 Season Liability Waiver
The Mississauga Crusaders Special Hockey Club is a Not for Profit organization with an Elected Board of Directors and members that have submitted an application to join the Not for Profit organization. A player is not automatically made a member and must submit an application to the Board of Directors who are responsible for approving new members. If you are not already a member and are interested in becoming one, please indicate below.
Member of Not for Profit Organization - Mississauga Crusaders Special Hockey Club
Payment of Fees
Payment can be made by:
(1) Electronic Money Transfer (Interac) by sending payment to mississaugacrusaders@live.ca with the password 24hockey
(2) Other - please state how you will be paying in the comments box.
Payment Method
Please select one of the payment options below. New uniforms will be purchased this season for all players and is included in the registration fee.