Pre-Season Skills Camp Registration (Plattsville & District Minor Hockey)
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Pre-Season Skills Camp Registration
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Pre-Season Skills Camp Registration
Group 1: Minor Novice, Novice (birth years 2012, 2011), Saturday Sept 14 9:00-10:00am and Thursday Sept 19 5:00-6:00pm. Group 2: Atom/Peewee (birth years 2010-2007), Saturday Sept 14 10:30-11:50am and Thursday Sept 19 6:00-7:20pm
Participant Information
Participant's Name:
*
Required
Date of Birth (Year only):
*
Required
List any medical conditions:
Age Group Attending:
*
Group 1: Minor Novice / Novice
Group 2: Atom / Peewee
Required
Payment Option:
*
Select One...
Will pay the day of the event
Pay now, via PayPal, Minor Novice / Novice registration -- $20.00
Pay now, via PayPal, Atom / Peewee registration -- $30.00
Required
Player/Parent Contact Infomation
Parent/Guardian Name:
*
Required
Email Address:
*
Required
Example:
[email protected]
Phone/Cell Number:
Example: ###-###-####
Emergency Contact (for the day of):
*
Required
Emergency Contact's Phone/Cell Number:
*
Required
Example: ###-###-####
Waiver:
The undersigned is responsible for the conduct of the player while participating in this event. It is understood that the undersigned person is of legal age or a legal guardian, and shall not hold the program/event or its organizers, officials or facility used, liable in the event of injury or loss in any manner whatsoever.
I also certify that my child is in good health with no chronic illness or abnormal tendencies. The player listed above is registered under the care of the undersigned who assumes all risks through the enrollment in the program/event which consists of physical interaction capable of injury.
The player must be registered with Plattsville & District Minor Hockey Association, and wear full hockey equipment during the on-ice sessions.
I agree to the terms and conditions stated above
*
Waiver
Signed by:
*
Required
Date:
*
Required
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