|
|
| I usually play: Forward
Defense
Goalie |
|
|
|
|
| Please
register me for the following camp: |
Price |
|
Day Camp 1: July 16 - 20, 2007
(9:00 A.M. - 4:00 P.M.)
I will be a Mite Squirt PeeWee Bantam next season |
$ 315 |
|
Day Camp 2: July 30 - August
3, 2007
(9:00 A.M. - 4:00 P.M.)
I will be a Mite Squirt PeeWee Bantam next season |
$ 315 |
|
Travel Skills Camp/Adult Evening Camp |
Not Offered in 2007 |
Use my credit card billing information below
(either click Order to submit it
electronically on this secured site, or print and fax this form)
Enclosed is my
check for the entire amount.
Enclosed is my non-refundable deposit
of $50.00. (I will pay the balance before June 1, 2007). |
| Use this section if paying by credit card (either
electronically, or print and mail or fax this form). Card Type:
Visa Master Card Amount of this payment: $
Card Number:
Expiration:
of
Important: By filling in your name
and authorizing payment by credit card, you acknowledge that the participant or his or her
guardian agree West Michigan Hockey Camp, Inc and the Skating Rink will not be liable for
accident or loss, however caused, and agrees to release the proprietors and/or Skating
Rink from any and all damages which may occur as a result of any such accident or loss. |
If you prefer not to register on-line, print and mail this form with your check payable to
West Michigan Hockey Camp, Inc.
P.O. Box 917
Grand Haven, MI 49417
616-846-4830
Liability Waiver: The participant or his or her legal guardian agree
West Michigan Hockey Camp, Inc. and the skating rink will not be liable for any accident
or loss, however caused, and agrees to release the proprietors and/or skating rink from
any and all damages which may occur as a result of any such accident or loss.
Signature:__________________________________ Date _______________
|
