Power Hockey Development Inc.
The Hockey Training Company
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PROGRAM REGISTRATION & CREDIT CARD
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NT (at the bottom)
PLEASE SELECT PROGRAM:
Skills Weekly Clinic (May/June)
Midget/Junior Skate (May/June)
Spring, 2011 AA
Spring, 2009 A
Spring, 2007 A
Spring, 2006 AA
Spring, 2006 A
Spring, 2005 AA
Spring, Elite Brick '10
Name of Parent
Parent - Email Address
Parent - Cell Number
Full Name of Player
Player - Birthdate (M/D/YEAR)
Position
Player - Cell Number
Player - Home Number
Player - Email Address
Player - Current Season Team
Player - League/Division/Level
AAA
AA
A
Select
House League
Past Season Stats
Player - Health Card #
I Agree
By selecting 'I AGREE' you are confirming that the information listed above is correct to the best of your knowledge and that by clicking 'SELECT HERE TO SUBMIT' you are providing a digital signature
Release of Liability & Waiver Agreement
I give my approval to my childs participation in Power Hockey Development activities and agree that Power Hockey Development, its proprietors and employees will not be responsible for any accident or loss however caused and agree to release the proprietors from all claims and damages which may arise as a result of such accidents or loss. In the event of inability to contact me, I hereby give you permission to seek out any necessary medical assistance my child requires while attending your program. In signing the application, I hereby acknowledge that I have read and understand the conditions and certify that the applicant is in good physical and mental health.
PRESS HERE - To Submit Registration & Waiver
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