Summer Advanced Camp 2012 Registration

(July 30-Aug. 3)     (Aug. 6 thru 10)     (Aug. 13 thru 17)

1111 Speers Road, Oakville, ON

Client Information
Mr. Mrs. Miss Ms.    
Last Name
First Name
Middle Name
 
Student Information
Student's Name
Sex
M F
Current Level
A AA AAA JR
Date of Birth
Age
Other, Please Specify
Jersey Size S M L XL 2XL 3XL 4XL Don't Know
Street Address
City
Province/State
Postal/Zip Code
Country
 
Home Phone No.
Office Phone No.
Fax No.
 
Email Address
Emergency Contact Name
Emergency Contact Phone No.
    Health Card No.
 
Choice Of Week
July 30-Aug. 3 August 6-10 August 13-17
 

PRICE:  $725.00 + HST

Payment Terms:  50% of payment + HST payable at time of registration.  Balance of payment + HST payable by July 3, 2012.

 

If for any reason we must cancel a program a full refund will be issued.

CANCELLATION AND REFUND POLICY
There will be no refunds after July 3.  Anyone requesting a refund after July 3 for medical reasons will be issued a credit against future instruction less a $50.00 administration fee.  There is no reduction in fees for late arrivals, missed days or early departures.  Payments received that are not negotiable will be subject to a $25.00 service charge.  There is no transfer of unused, prepaid camp time to future services. Please plan your camp registration carefully.

Health Certification:
“In signing/completing the application, the parent/guardian certifies that the student is in good health”.

WAIVER:
I agree that I shall provide health insurance or other applicable insurance to cover any personal injury and property damage sustained by the student while participating in the activities of or while on the premises of ice2ice and that in connection with the ice consideration of the services provided in the hockey/goaltending program.  I/We understand and appreciate that the participation AND OBSERVATION OF THE SPORT of hockey constitutes a risk to me/us of serious injury, including permanent paralysis or death.  I/We hereby release and forever discharge ice2ice/RMGS and /or it’s proprietors, instructors, employees, contractors and associates from all demands, causes of action, suits or liabilities for personal injury and/or property damage which I/we as a student, or my/our child as a student, or I myself may have as a result of participating in said program.  I hereby give you permission to seek out any necessary medical assistance myself/my child may require while attending the program.  I have read and understand the policies outlined above.    

 
Payment Method Visa MasterCard Cheque Cash

Payments by cheque or cash must accompany registration form before confirmation of attendance will be issued.

Card Number
Expiry Date
Name on Card
 
Clicking the submit key verifies the parent agrees to all of the terms in regards to our Cancellation & Refund Policy, Health Certification and Waiver.
 
 

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