2008 SPRING HOCKEY SKILLS CAMP REGISTRATION FORM

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

Edges PSI
13017 - 137A Street
Edmonton, Alberta
T5L 5A3

Please note that a $25 fee will be charged for all returned cheques.

NAME:______________________________________________________________________________________________CAMP (circle) 1 2 3 4 Women

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?__________________________________________________________________________________________________

Camp (Circle): 1 2 3 4 Women: $______________

5% GST: +_____________________________
GST Reg #: 88216 5723 RT0001

TOTAL COST: $_______________________________

No refunds or credits will be issued unless the program is cancelled by Tammy Coley. In consideration of the benefits awarded to us by acceptance of this application, the undersigned agrees to save and hold harmless and release Edges Professional Skating Instruction, Tammy Coley, all coaches and assistants, and any private or municpal rink of and from any and all claims rising from bodily injury and property damage sustained by the student and is fully aware of the cancellation policy. All skaters must wear full CSA Approved hockey equipment and bring a stick.

DATE:___________________ SIGNATURE (Parent or Guardian):__________________________