Hockey School Online Form

FALL HOCKEY SCHOOL REGISTRATION FORM

2010

Please complete, print, sign and remit to:

Premier Skating

42 Fullerton Crescent

Markham, Ontario L3R 3G5

* First Name:* Last Name:* Age:

*Address: * Apt:

* City: *Province: * Postal Code:

* Hm. Phone: * Business Phone:

* Email:

Click HERE for Course # & fees then (click back to return to form)

* Please Select from the following options:

*Course #: *Skating Background:

This school reserves the right to place any student in the group/class which in the schools opinion, best suits the skaters ability. Grading is thus based on ability and not age. Any cancellations are at the sole discretion of this school, and any resulting rebates are subject to an administration charge of 15% of the applicable fees. Refunds will ONLY be considered for medical reasons, and MUST be received by this office IN WRITING along with a physicians certificate. This school reserves the right to vary, amend, modify or cancel any & all parts of this program without notice. This school further reserves the right to use any picture(s) taken during the courses for advertising purposes. The undersigned parent/guardian of the above named student further authorizes PREMIER SKATING its associated companies and/or its representatives to obtain any medical aid that may be required by the said student, as a result of an injury sustained during the course, and the undersigned hereby releases, indemnifies and saves harmless PREMIER SKATING and its associated companies, also their representatives from any and all claims for loss and/or injury, howsoever caused. If you require a receipt or confirmation, you MUST REQUEST one by either sending along a self addressed stamped envelope or print your e mail address clearly on the form

(I UNDERSTAND THERE ARE NO REFUNDS OR MAKE-UP CLASSES

GST registration # R1324621136

I HAVE READ AND AGREE TO THE ABOVE:

* _______________________________signature (parent/guardian)

*Please type your name:

Date:

Enclosed please find $

Payment by:

We accept cash—cheque—money orders only. Applications are accepted on a first come first served basis. Unfortunately spaces may not be held over the telephone. Any returned cheques are subject to an administration charge of $25.00.