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Send To: Hockey Techniques PO Box 401 Oxford, NJ 07863 or Fax to: (908) 453 - 2436 Registration Policies ALL Programs
ALL summer camps except Vacation Camp (Before
March 1st): A signed application and waiver, accompanied by a $50
non-refundable Vacation Camp
All Programs listed as Clinics (September - May) Initial Deposit: 50% of cost of clinic if
more than 1 month in advance. Cancellation - Refund - Credit Policies
PersonalCamper's/Family Name: _______________________ B-Day(s): __________ Address: _____________________________________________ City: __________________State: _______ Zip: __________ Day Tel. #: ________________ Night Tel. #: ________________ Parent/Guardian Name: ________________________________ Current Team: ____________________________ Position: _____ Email:________________________________________________ I will be coming with my friend(s): ______________________________________
PaymentCheck/Visa/MasterCard/Discover: Camp Amount: $_____ Video(s) Amount: $_____ Credit Card #:__________________________________Exp.: ____ V-Code (Back of card last set of numbers): ______________ Signature: ___________________ Print Name:______________ WaiverI/we agree with all registration/cancellation/refund policies. I/we also acknowledge that hockey is a contact sport and that the activities associated with and on the premises of Drevitch’s Hockey Techniques, LLC. program constitutes a risk of personal injury, which includes but is not limited to paralysis, permanent disabilities, and or death. In consideration of this, I agree to provide health insurance and appropriate insurance to cover any personal injury or property damage while on the premises of Drevitch’s Hockey Techniques, LLC. I attest that the player is of good health and is able to participate in the physical activities of a rigorous program. In addition to this, I give Drevitch’s Hockey Techniques, LLC consent to follow proper emergency procedure with my son/daughter. I/we will not hold Drevitch’s Hockey Techniques, LLC responsible for items lost, stolen or damaged in and around the premises of the program. I/we hereby release and forever discharge Drevitch’s Hockey Techniques, LLC, its coaches, staff, and agents from all damages, causes of action, suits or liable for any accidents, personal injury and or property damage which I/we as a student, or my child as a student, or myself may have as a result of participating in said program. I/we also give Drevitch’s Hockey Techniques, LLC permission to use any pictures and videos taken during the program for research, instruction, and/or advertising purposes. Signature: _______________________ Print Name: _______________Date: _________ |
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