Gear Form
Player Name ____________________________________________________________________
Parent Name ____________________________________________________________________
Address ____________________________________________________________________
Home Ph ___________________________ Mobile __________________________
Grade ____________________________________________________________________
ID Type ___________________________ ID Number __________________________
Borrowed Gear Type Details
Helmet
Stick
Gloves
Elbow Pads
Shin Pads
Skates
Top
Other
I agree to return the above listed gear at the completion of the grade and store it securely and pay
replacement value for any gear that I am unable to return in working order, with the exception of
normal wear and tear associated with the playing of ice hockey.
Parent Signature ___________________ DIHA Signature ___________________
Borrow Date ____________ ______ Bond Paid ___________________
Complete upon return
Parent Signature ___________________ DIHA Signature ___________________
Return Date ____________ ______ Bond Returned ___________________