444 Province Road Laconia, NH 03249
TRAINING CAMP HOCKEY REGISTRATION
PARTICIPANT REGISTER HERE & SUBMIT!
Participant's First
Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Parent's Primary
E-mail
Parent's Home Phone
Parent's Work Phone
Parent's Cell Phone
Any additional
contact information you wish to supply (secondary e-mail, alt.
phone, or special medical instructions, etc.)
Select any of the following options that apply:
Register
me for the YOUTH Training Camp (MITE/SQUIRT) (ages 6-10)!
Register
me for the YOUTH Training Camp (PEWEE/BANTAM) (ages 11-14)!
Register
me for the ADULT Training Camp!
Level for next season?
Please provide the following information:
Date of Birth
Age During Camp dates
Position?
Shot?
How did you hear about us?
How would you rate your level of hockey experience?
I have the following question or comment:
PARENTS WILL
BE ASKED TO SIGN THIS WAIVER PRIOR TO CAMP
TRAINING
CAMP HOCKEY - WAIVER & RELEASE
I
agree that I shall provide health insurance to cover any personal injury
and property damage sustained by the participant while participating in
any activities or while on the premises of Training Camp Hockey and the
Laconia Ice Arena; the
undersigned assumes all responsibility for any and all risk for damage or
injury that may occur to the above named person as a participant in the
Training Camp, including practices, games, skill sessions, clinics, and
other activities related to the program. In consideration of such, the
undersigned hereby releases and discharge the program, Laconia Ice Arena,
Will Fay, it's operators, employees, agents, supervisors, instructors, and
other players from all claims, demands, rights or cause of action present
or future, whether known or anticipated and resulting from or arising out
of or incident to the undersigned participation with the said program
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