7TH ANNUAL PRE-SEASON CAMP

 

PLEASE RETURN THIS INFORMATION SHEET TO: 

 

VALLEY ICE CENTER

ATTN:  SERA ROBINE

8750 VAN NUYS BLVD.

PANORAMA CITY, CA 91402

818.893.1784 x222

 

1.  PLAYER’S PAYMENT IS DUE AT THE BEGINNING OF THE CAMP = $425-Skater, $325-Goalie

(MAKE CHECK PAYABLE TO “VALLEY HOCKEY SCHOOL”).

2.  ALL PLAYERS MUST SIGN A VIC WAIVER FORM.

3.  ALL PLAYERS MUST REGISTER FOR USA HOCKEY INSURANCE AND COMPLETE A CONSENT

FORM FOR THE 2007/2008 SEASON (NOT NECESSARY IF ALREADY PLAYING ON A SCAHA  

OR IN-HOUSE TEAM).  PLEASE BRING PROOF OF USA HOCKEY INSURANCE.

 

            PLEASE PRINT CLEARLY

 

            Players name                                                                                                                                     

 

            Parent/Guardian’s name                                                                                                                    

 

            Address                                                                                                                                              

 

            City                                                                              State                            Zip                              

            Home                                            Work                                             Cell

            Phone #                                         Phone #                                         Phone #                                  

                                                                                                                                  

            EMAIL ADDRESS (MANDATORY):                                                                                                

 

In consideration of the participant and his/her parent being to register the participant, and participate in the 7th ANNUAL PRE-SEASON CAMP AT VALLEY ICE CENTER, we do hereby forever release and discharge VALLEY ICE CENTER, its Directors, Employees and any person or corporation connected herewith from all manner of action, injury, damages, costs, claims or demands which we shall or may hereafter have, suffer or receive by reason of such participant in the program of the facility. The release shall be binding on our heirs, assigns, executors and administrators. It is agreed that VALLEY ICE CENTER does not and shall not be considered to guarantee or warrant such equipment as may be used in the conducting of said camp. It is further agreed that VALLEY ICE CENTER is not responsible for lost or stolen personal articles. There are no exceptions, so please clearly mark and initial all articles.

 


            PAYMENT METHOD:          Check            Cash       Amex          VISA       Mastercard

 

Amount:                                              Credit Card #:                                               Exp. Date:

 

Signature:                                                                  Date:                          

 

Thank you and have a great camp!