Powered by
www.facebook.com/IndoorPondHockeyClassic www.phantoms.be - www.hockey-community.com
TEAM REGISTRATION FORM
I, ………………………………………………………, Team Captain of ……………………………………………..
hereby register my TEAM to participate in the 4th Indoor Pond Hockey Classic at ijsbaan
Ruggeveld in Antwerp (Deurne). I pledge we will play in the true IPHC Fair-Play Spirit!
TEAM NAME
ADDRESS
CITY
COUNTRY
e-mail
Website
Social Media
The followingplayers willparticipate and I declare that all players have insurance (RBIHF or
otherwise).
NAME T-Shirt Size Amount 75€/pp
1. Goalie:
2. Player:
3. Player:
4. Player:
5. Player:
6. Player:
7. Player:
8. Player:
Total:
Due to popular request, younow also have the possibility to order catering for accompanying
persons (BBQ, lunches & snacks).
NAME Adult 40€/pp – Child 30€/pp
1. Non-player:
2. Non-player:
3. Non-player:
4. Non-player:
5. Non-player:
6. Non-player:
7. Non-player:
Total:
 Complete&return to: indoorpondhockeyclassic@gmail.com
 Pay the amountdue via the followingbankaccount:
 AntwerpPhantoms - Ruggeveldlaan488 -2100Deurne -TVA:0430.619.721
BNPPARISBASFORTIS– IBANBE29001497851364-BIC: GEBABEBB
Don'tforgetto mention‘PondHockey -TeamName’ and‘N° ofparticipants’
Powered by
www.facebook.com/IndoorPondHockeyClassic www.phantoms.be - www.hockey-community.com
OPTINAL HOODIE* ORDER FORM
NAME Hoodie
Size
Amount €
1. Goalie: 45
2. Player:
3. Player:
4. Player:
5. Player:
6. Player:
7. Player:
Total:
 Complete & return to: indoorpondhockeyclassic@gmail.com
 Pay the amount due via the following bank account:
BNPPARISBASFORTIS – IBAN BE29 0014 9785 1364 - BIC:GEBABEBB
 Don't forget to mention ‘Hoodies’ & ‘your Team Name’ and ‘N° of
participants’
*For this year’s edition we opted for the vintage colors of the defunct Vancouver
Millionaires for the official T-shirt and Hoodie of the Indoor Pond Hockey Classic

4th iphc2016 empty registration form

  • 1.
    Powered by www.facebook.com/IndoorPondHockeyClassic www.phantoms.be- www.hockey-community.com TEAM REGISTRATION FORM I, ………………………………………………………, Team Captain of …………………………………………….. hereby register my TEAM to participate in the 4th Indoor Pond Hockey Classic at ijsbaan Ruggeveld in Antwerp (Deurne). I pledge we will play in the true IPHC Fair-Play Spirit! TEAM NAME ADDRESS CITY COUNTRY e-mail Website Social Media The followingplayers willparticipate and I declare that all players have insurance (RBIHF or otherwise). NAME T-Shirt Size Amount 75€/pp 1. Goalie: 2. Player: 3. Player: 4. Player: 5. Player: 6. Player: 7. Player: 8. Player: Total: Due to popular request, younow also have the possibility to order catering for accompanying persons (BBQ, lunches & snacks). NAME Adult 40€/pp – Child 30€/pp 1. Non-player: 2. Non-player: 3. Non-player: 4. Non-player: 5. Non-player: 6. Non-player: 7. Non-player: Total:  Complete&return to: indoorpondhockeyclassic@gmail.com  Pay the amountdue via the followingbankaccount:  AntwerpPhantoms - Ruggeveldlaan488 -2100Deurne -TVA:0430.619.721 BNPPARISBASFORTIS– IBANBE29001497851364-BIC: GEBABEBB Don'tforgetto mention‘PondHockey -TeamName’ and‘N° ofparticipants’
  • 2.
    Powered by www.facebook.com/IndoorPondHockeyClassic www.phantoms.be- www.hockey-community.com OPTINAL HOODIE* ORDER FORM NAME Hoodie Size Amount € 1. Goalie: 45 2. Player: 3. Player: 4. Player: 5. Player: 6. Player: 7. Player: Total:  Complete & return to: indoorpondhockeyclassic@gmail.com  Pay the amount due via the following bank account: BNPPARISBASFORTIS – IBAN BE29 0014 9785 1364 - BIC:GEBABEBB  Don't forget to mention ‘Hoodies’ & ‘your Team Name’ and ‘N° of participants’ *For this year’s edition we opted for the vintage colors of the defunct Vancouver Millionaires for the official T-shirt and Hoodie of the Indoor Pond Hockey Classic