CARHA Hockey Insurance

Our registration file is awaiting additional info!!! Please respond before September 22nd 2010

Please click on the comment button and supply the following information which will be used exclusively by CARHA for Insurance registration. Should you already have CARHA Insurance or are considering obtaining it with another team please also let us know so we don't pay it twice.

First Name
Last Name
Date of Birth
Email address(es)
Home Address
City
Province
Postal Code
Home Phone Number
Work Phone Number
Cellular Phone Number
Fax Number