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Hockey School Registration Form

Name:
Address:
City:
Province:Postal Code:
Home Phone:Work Phone:
Fax:Cellular:
Email:**Required
Age:Birth Date:
 
Level of Hockey: Beginner 
Intermediate  
Advanced 
Minor Rep Level   
Minor House Level
Adult Rep Level 
Adult Recreational Level  
Position:
Years Played:
Summerland School: (Reserve a place in the following)
Price:
Day Program Only: $429.00 plus GST
Room and Board Only: $569.00 plus GST
Lunches Only Program: $40.00
Full Meal Program: $150.00
July 13-19
 Program A: Advanced
 Program B: Skills Development
 Program C: Goalies Only
 Program D: Regular
Room and Board Required? Yes No
Vegetarian Meals? Yes No 
(With Vegetarian meals: add $40.00 to Room and Board cost
Whistler BC: August 18-22  
 Adult Only Day Program Only - $329.00 plus GST
 Girls Only Hockey Camp Only - $329.00 plus GST
 Adult Evening Program Only  - $130.00 plus GST

Parent or Player Consent Form

I have read the complete program descriptions and agree to the terms as described therein. I certify that all the guidelines on the application shave been answered correctly and I understand that my child/I will provide their/my own skates, stocks and equipment.

Name of Player: 
Relationship: 
I,  hereby accept the terms of this application and registration and hereby release, remise and forever discharge the Centre Ice Female Hockey School, and its directors or agents and all persons associated with its firm and all liability whatsoever or responsibility whatsoever for accidents or injuries, whether fatal or otherwise, which may occur incidentally to or arising directly or indirectly out of Centre Ice Hockey School.

This is also my written permission to have myself/my child admitted and attended to for medical or dental treatment in case of sickness or injury. This release shall be binding on the players, heirs, assigned executors and administrators.

The Medical Number is

Payment Information

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