Registration form to the 4th edition of the Indoor Pond Hockey Classic

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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’

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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