Printable Registration Form

ALCAN Hockey Main Camp Printable Registration Form

MAIN CAMP REGISTRATION FORM

Please print out a copy of this form, complete, and mail to: ALCAN Hockey, PO BOx 80691, Fairbanks, AK, 99708
Or drop off at Play It Again Sports or Sport King in Fairbanks

If you have any questions please contact:
Alaskan Canadian Hockey Schools: phone (907) 455-4203

NAME: _________________________________________ AGE: ____________________

ADDRESS: _______________________________________________________________

CITY: _________________________________ STATE/PROV.: _____________________

ZIP/POSTAL CODE: _________________________

PHONE: _________________________ DAY TIME PHONE: _______________________

EMAIL: ____________________________________________________________________

LAST TEAM/AGE DIVISION: __________________________________________________

POSITION: __________________________________________________________________

HEIGHT: ________________________ WEIGHT: __________________________________

MEDICAL INFORMATION: (Allergies or any special conditions):__________________________

_____________________________________________________________________________

I WISH TO ATTEND & ENCLOSED IS A CHECK FOR THE FOLLOWING CAMP:

MAIN CAMP 2008
I wish to Attend (Please Check the Appropriate Space):

Camp 1:                            Camp 2:                              Camp 3 :                             Camp 4:
5& 6 Years Old                7 & 8 Years Old                 9 & 10 Years Old                11- 13 Years Old
($100 1 Hr /day): ___       Full Day ($325):___            Full Day ($325):___            Full Day ($325): ___
                                         Half Day ($225):___           Half Day ($225):___            Half Day ($225): ___
                                         *Deposit ($150):___           *Deposit ($150):___           *Deposit ($150): ___

* Deposit is non-refundable with balance due upon check-in at camp.

ALASKAN-CANADIAN HOCKEY SCHOOLS INSURANCE WAIVER

The applicant, his/her parents and/or guardians, acknowledge that ice hockey is a contact sport, and agree the ALASKAN-CANADIAN HOCKEY SCHOOLS, its agents, servants, employees, instructors, and directors, shall be held harmless and not liable for any injury or damage to the participants as a result directly or indirectly caused by attending the school. The applicant, his/her parents and/or guardians also agree to indemnify the UAF PATTY CENTER, and the UNIVERSITY OF ALASKA FAIRBANKS, their employees, agents, and managers from all claims and damages.

NAME OF PLAYER: ________________________________ DATE: __________________

SIGNATURE OF PARENT OR GUARDIAN: ______________________________________