PARENTS!! Please CLICK HERE before registering.
2012 SUMMER SKATING CAMPS REGISTRATION FORM
Mail Registration Form to: Edges PSI, 13017 - 137A Street, Edmonton, Alberta, T5L 5A3
$10 Early booking discount for registrations received before March 1st, 2012
Free Jersey & T-Shirt incuded with all camps!
PLAYER NAME:_______________________________________________ SUMMER CAMP (circle) A B C D E F
ADDRESS:_______________________________________ CITY:________________ POSTAL CODE:_____________
BIRTHDATE(mm/dd/yy):______________________________ PH: (H)_________________ (OTHER)________________
PARENT'S NAME(S):______________________________________________ LAST LEVEL PLAYED:______________
INJURIES OR HEALTH CONCERNS:___________________________________________________________________
HEALTH CARE #:___________________________ EMAIL ADDRESS________________________________________
HOW DID YOU FIND OUT ABOUT US?_________________________________________________________________
$10 Early booking discount for registrations received before March 1st, 2012
Camp (Circle): A B C D E F: $_______________
less discount(if applicable): -________________
SubTotal : =_____________________________
GST: +_________________________________
GST Reg#: 88216 5723 RT0001
TOTAL COST: $_______________________________
PAYMENT:
Cheque______ (A $25 fee will be charged for ALL returned cheques)
Visa_____ Mastercard_____ Card #_____________________________ Expires________
Cardholder Name_________________________ Authorizing Signature_______________
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 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):_____________________