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Championship Summer Hockey
School Application 2011
NAME_________________________________________________________________ ADDRESS______________________________________________________________ CITY________________________________ ZIP_______________________________ TELEPHONE____________________________________________________________ AGE_________ NO. OF YEARS EXPERIENCE________________________________ POSITION______________________________
WEIGHT________________________ CHECK ONE _____AUG.
15-19
_____ AUG. 22-26
SQUIRT/PEWEE
_______
_______
MITE/SQUIRT _______
_______
JERSEY SIZE PLEASE CIRCLE ONE SMALL YOUTH MEN MEDIUM YOUTH MEN LARGE YOUTH MEN X-LARGE YOUTH MEN
NOTE: WE ORDER THE SCHOOL JERSEYS ACCORDING TO THE SIZE LISTED ON THE APPLICATIONS, SO PLEASE LIST YOUR CHILDS CORRECT SIZE. THIS ELIMINATES ANY PROBLEMS THE FIRST DAY OF SCHOOL. THANK YOU.
ALL STUDENTS ARE REQUIRED TO HELMETS WITH FACE MASKS
I HEAR BY ABSOLVE HOCKEYTOWN U.S.A., INC. , THE CHAMPIONSHIP HOCKEY SCHOOL AND THEIR INSTRUCTORS FROM ALL LIABILITY FOR INJURIES TO THESE REGISTERED PERSONS DURING THESE SCHOOL SESSIONS. I HEREBY ATTEST THAT THE APPLICANT IS IN GOOD HEALTH AND ABLE TO PARTICIPATE IN THE PHYSICAL ACTIVITY OF A VIGOROUS ATHLETIC PROGRAM. IN THE EVENT OF INJURY OR ILLNESS, THE SCHOOL HAS MY PERMISSION TO PROVIDE EMERGENCY FIRST AID CARE
________________________________________________________________________________________________
DATE_________________________________ THE COACHING STAFF RESERVES THE OPTION TO CHANGE THE CURRICULUM WHEN IN THEIR OPINION IT BECOMES NECESSARY FOR IMPROVEMENT TO THE STUDENTS OVERALL ABILITY AS HOCKEY PLAYERS.
Please print and mail to: Hockeytown USA, |
