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Hall of Fame Title

Please mail this completed form to Ken Bray, Playmakers Tournament Registrar, 2425 Dunlevy St. Victoria, BC V8R 5Z1. Thanks for your interest in this induction. If you have any questions please do not hesitate to contact us.

 Name
 __________________________
Birth Date (eg: May 30, 1938)
 __________________________
Place of Birth
 __________________________
Present Address
 __________________________
__________________________
__________________________
Team name at this year's tournament
 __________________________
Would you please  share your most memorable hockey moment with us?
 __________________________
__________________________
__________________________
__________________________
__________________________
__________________________
Who was the most influential person in your life of hockey?
 _________________________
_________________________
_________________________ 

 

Thank you for completing this application.  We look forward to inducting you at the banquet during the Tournament.

Organizing Committee
Playmakers Old Timers Hockey Tournament
Victoria, BC

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Publish date: January 5, 2012
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