2008/2009 Puckhandling & Shooting Mini-Camps

*Please make cheques and money orders payable to EDGES PSI and mail them
along with this form to:

Edges P.S.I.
13017 - 137A Street
Edmonton, Alberta
T5L 5A3

GST Reg #: 88216 5723 RT0001

PRE-SEASON CLASSES (Circle):

1 (Pee Wee Checking) -----2 (Pre-Novice) ----- 3 (Novice)-----4 (Atom)

CHRISTMAS BREAK CLASSES (Circle):

1 (Pre-Novice) ----- 2 (Novice) ----- 3 (Atom) ----- 4 (Stick Tricks)

NAME:_____________________________________________

ADDRESS:__________________________ CITY:________________ POSTAL CODE:_____________

BIRTHDATE(mm/dd/yy):_________________ PH: (H)__________________ (W)___________________

PARENT'S NAME(S):__________________________ LAST LEVEL PLAYED:____________________

INJURIES OR HEALTH CONCERNS:_____________________________________________________

HEALTH CARE #:___________________________ EMAIL ADDRESS__________________________

HOW DID YOU FIND OUT ABOUT US?_________________________

CLASS(ES):___________________ TOTAL COST(With GST): $________________

PAYMENT(Circle): CASH/CHEQUE ENCLOSED
*A $25 fee will be charged for all NSF Cheques

No refunds or credits will be issued unless the program is cancelled by Superskate Advanced Hockey Development Association or Edges Professional Skating Instruction (Tammy Coley). In consideration of the benefits awarded to us by acceptance of this application, the under signed agrees to save and hold harmless and release Superskate Advanced Hockey Development Association, Edges Professional Skating Instruction, Tammy Coley, all coaches and assistants, and any private or municpal rink of and from any and all claim rising from bodily injury and property damage sustained by the student. All skaters must wear full CSA Approved hockey equipment.

DATE:____________________ SIGNATURE (Parent or Guardian):____________________________