Livermore 2016 Summer Camp Registration

Livermore 2016 SUMMER
Goalie CAMP

Registration & Waiver Form
Hosted by: Mites 2 Midgets Goalie Coaching at Tri Valley Ice

* Indicates required field

Goalie's Name: *

First

Last

Goalie's Age - Please Select One: *

Parent/Guardian 1 Name: *

First

Last

Email *

Phone Number *

Prarent/Guardian 2 Name: *

First

Last

Email *

Phone Number *

Please Confirm the Event Your Goalie Will Be Attending: *

My goalie will be attending the 2016 Summer Goalie Camp hosted by Mites 2 Midgets Goalie Coaching at Tri-Valley Ice, Livermore, CA on July 11-15, 2016.

In consideration of being allowed to participate in any skating/sports program and related events and activities:

1. The risk of injury from activities involved in these programs is significant, including the potential for permanent paralysis and death. While particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury does exist.

2. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases( as defined below) or others and assume full responsibility for my/ my child's participation.

3. I willingly agree to comply with any rules and regulations of the facility. If, however I observe any unusual significant hazard in participation, I will bring such hazard to the attention of the nearest official immediately.

4. I, myself and on the behalf of my heirs, assigns, personal representatives and next-of-kin, herby release and hold harmless all members of the hosting facility and anyone associated with Mites 2 Midgets Goalie Coaching and Tri Valley Ice, Livermore, CA.

Required to Complete Registration: *

I have read this release of liability and assumption of risk agreement, fully understand its terms and understand that I have given up substantial rights by signing it freely and voluntarily without any inducement.

Your Intials *

Submit Form & Make Payment

What We Do

Livermore 2016 SUMMER Goalie CAMP

Livermore 2016 SUMMER
Goalie CAMP