ONLY FILL OUT THIS FORM IF YOU ARE A HOUSE LEAGUE GOALIE OR A PARENT OF A HOUSE LEAGUE GOALIE WHO HAS PLAYED A GAME FOR A TEAM YOU ARE NOT ROSTERED ON.
THIS FORM MUST BE COMPLETED WITHIN 48 HRS OF THE COVERED GAME.
GOALIE CREDITS ARE $20 PER GAME (NO EXCEPTIONS) AND ARE APPLIED TO THE 2026-27 SEASON
ALL GAMES WILL BE VERIFIED BY WMHA USING ELECTRONIC GAMESHEETS