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| Last Name | | |
Age (at start of program) | | |
| Past Participant New Participant | |
| Street Address | | |
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| Cell Phone Number | | |
| E-mail Address | | |
Medical Problems | | |
| Parent or Guardian's Name | | |
| Parents Work Phone | | |
Last Hocky Level Played and Division | | |
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| Where did you hear about Tucker Hockey Progams? | | |
If you chose "Poster" in the above question, please indicate which arena you saw the poster at. | | |
Will you be taking advantage of our Buddy Referral Program? If yes, please provide details in the Comments Field. Please Note: If you're participating in the Buddy Referral Program payment can only be made over the phone with a credit card. | |
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Spring Minor 2012 April to June | Group 3: (Ages 7-9) Saturdays; 1:15-2:15 PM April 14 to June 23 - No Session May 19 (12 Spots Left) Please Note: Group 1 is Full. Please register in Group 3. Group 2 is Full - waiting list now open. Please fill in form and indicate in comments field your request for the waiting list.
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Summer Minor 2012 August | Group 1: (Ages 7-9) Monday to Friday; 5:30-6:45 PM Aug 13-17 Group 2: (Ages 10-12+) Monday to Friday; 7:00-8:15 PM Aug 13-17 Group 3: (Ages 7-9) Monday to Friday; 5:30-6:45 PM Aug 20-24 Group 4: (Ages 10-12+) Monday to Friday; 7:00-8:15 PM Aug 20-24 Group 5: (Ages 7-9) Monday to Friday; 5:30-6:45 PM Aug 27-31 (Full - Waiting List Only) Group 6: (Ages 10-12+) Monday to Friday; 7:00-8:15 PM Aug 27-31 Shooting Clinic Group 1: (Ages 10-12+) Monday to Friday; 8:30-9:45 PM Aug 27-31 | |
Spring Elite 2012 April to June | Group 1: (Atom & Peewee) Saturdays; 12:00-1:00 PM April 14 to June 23 - No Session May 19 Group 2: (Bantam/Midget) Saturdays; 10:45-11:45 AM April 14 to June 23 - No Session May 19 | |
| Summer Elite 2012 August | Group 1: (Peewee & Bantam) Tuesday to Saturday; 7:30-8:45 PM Aug 7-11
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| Summer Checking 2012 August | Group 1: (Ages 10-13+) Tuesday to Saturday; 6:00-7:15 PM Aug 7-11 |
| Technical & Tactical Program - Spring & Summer 2012 | Summer: (Bantam/Midget Elite) Tuesday to Saturday; 9:00-10:15 PM Aug 7-11 |
Comments
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RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT PLEASE READ THIS CAREFULLY Warning: By agreeing to this waiver, you give up the right to sue for any injury or damage however caused. To: TUCKER HOCKEY ENTERPRISES LTD., and its employees, representatives, officers, directors and agents (collectively referred to as “Tucker Hockey”) I am in agreement on behalf of myself, my personal representatives, heirs and assigns. | 1. | I acknowledge that participating in the activities offered by Tucker Hockey involves inherent risks that may cause accident, injury and damage to myself and my property. | | 2. | I fully understand the risks and dangers associated with my participation in these activities and accept them entirely at my own risk. | | 3. | I hereby waive any and all claims which I may have against Tucker Hockey and release Tucker Hockey from all liability for injury, property damage or any other loss sustained by me as a result of my participation in these activities, due to any cause whatsoever. I further agree to indemnify Tucker Hockey for any and all legal fees (on a solicitor and own client basis) or costs which may be incurred defending any lawsuit or claim I and my representatives may bring against them. | | 4. | I hereby grant permission to Tucker Hockey and its representatives to take photographs or videos of me and to make recordings of my voice. I further grant to Tucker Hockey and its representatives the right to reproduce, use, exhibit, display, broadcast, distribute and create derivative works of these images and recordings in any media now known or later developed. I acknowledge that Tucker Hockey owns all rights to the images and recordings. I hereby waive any right to inspect or approve the use of these images or recordings or of any written copy. I also waive any right to royalties or other compensation arising from or related to the use of the images, recordings or materials. | I HAVE READ AND FULLY UNDERSTAND THE ENTIRE CONTENTS OF THIS AGREEMENT. I UNDERSTAND THAT THIS DOCUMENT CONTAINS A PROMISE NOT TO SUE THE COMPANY AND THE COMPANY EMPLOYEES AND IS A RELEASE AND INDEMNITY FROM ALL CLAIMS.
I have read and agree with the Liability Agreement | |
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