World Class Hockey Development - Hockey Schools, Summer Camps, Youth and Adult Leagues

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Registration Form (to be used for all programs)

Players Name:

Birthdate:

mm/dd/yy

Street:

City:

Prov/State:

Postal/Zip:

Home Phone:

Work Phone:

Cell Phone:

Email:

Health Insurance #:

Team:

Level:

Residence Payment (Summer Only)

Residence Fees (based on five nights stay, Sunday through Thursday)---$350. CAN $300. US
Each extra weekend night add---$70 CAN $60. US

Enter Camp Program #'s

x $350./ $300.=$

Number of extra weekend nights

x $70./ $60.=$

Residence Total:=$

Please fill in camp info below:

Program #

Program Name

Date

Cost

Add Residence total:

Payment Total:

Comments/Request:

PAYMENT METHOD

Card Type

Card#

Exp:

mm/yy

World Class Hockey Policies:
1. Customer will be charged $50.00 administration fee for returned cheques.
2. Cancellation Policy: Full refund before April 15th. 50% refund, 50% credit up to 28 days prior to camp. No refunds will be issued there-after. Credits may be issued due to injury only. Medical record must be sent within two weeks of injury in order to qualify for credit.
3. Customer will be charged $50.00 for cancellation at any time.

By pressing the" Send " button on this page The applicant agrees that WORLD CLASS HOCKEY and/or it�s proprietors will not be held responsible for any accident or loss however caused, and agrees to release the proprietors from all claims or damage which may arise as a result of any such accident or loss. In event of an inability to be contacted, I hereby give WORLD CLASS HOCKEY permission to seek any medical attention required.

Parent/Guardian Name:

World Class Hockey Development - Hockey Schools, Summer Camps, Youth and Adult Leagues