Tournament Cheque Request (West Lorne Comets)

Print Tournament Cheque Request

Complete and Submit to request a PSMHA Cheque for entry into a tournament.

Team Requesting Cheque^*
Contact Person: Name^*
Contact Person: Phone #^*

Example: 123-456-7890
Contact Person: Email^*

Example: [email protected] Your submission will be sent to this address.
Date(s) of Tournament^*
Amount: $^*
Payable To:^*
I acknowledge that the tournament advance may not be processed if this information is not provided a minimum of six weeks before the tournament.

I acknowledge that any funds advanced, by WLMHA, to my team, must be repaid within two weeks of the end of the tournament.

I agree to the terms and conditions stated above^*