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Hockey School Registration Form

First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Home Phone:
Work Phone:
Fax:
Cellular:
Email Address:
Age:
Birth Date:
Level of hockey: Beginner
Intermediate
Advanced
Minor Rep Level
Minor House Level
Adult Rep Level
Adult Recreational Level
Position Played:
Years Played:
Reserve a place in the following: Day Program only - $459.00 plus Tax
Day Program with Room and Board - $619.00 plus Tax
Lunches Only Program - $55.00
Full Meal Program - $180.00
Select a Program:
Payment Information: Cheque or money order mailed (payable to CIFHS).
Visa Payment - We will call for Visa details.
MasterCard Payment - We will call for MC details.

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