Camp Information

 July 12-16 Arctic Ice Arena (Orland Park)     July 26-30 Winnetka Ice Arena (Winnetka)

Player Information

^{Name:       Date of Birth:}       

^{Address:  City:} AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA PR RI SC SD TN TX UT VT VA WA DC WV WI WY ^Zip:   

^{Home Phone#:    Parent Work#:  Cell#:}  

^{Height:      Weight:         Shot:}  Right Left Catch Right (goalie) Catch Left (goalie)    

^{2002-03 Team:            E-Mail:}       

Payment Information:     

^{Payment Method:} Visa American Express MasterCard Check Cash     ^Amount:  $395.00

^{Card/Check Number: Exp Date:} Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2004 2005 2006 2007 2008 2009

To pre register, make your check made payable to:
Complete Hockey
 Complete and print this form and mail to:

Complete Hockey Selects
708 Teri Lane
Yorkville, IL 60560

or fax it to 630-553-8992

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Enrollment Agreement & Release

In consideration to my enrollment and participation in The For Defensemen Only Camp (hereinafter referred to as CH), I hereby release and discharge CH, together with their agents, employees, officers, owners, volunteers, and all other participants forward on behalf of myself, my children, my parents, my heirs, and assigns as follows:
1.    I acknowledge that the sport of hockey involves known and unknown risks which could result in physical or emotional injury, paralysis, death, or damage to participants, to myself, to property, or to third parties, and that such risks simply cannot be eliminated. To that end, I further acknowledge that CH is not responsible for a participant¹s fitness, abilities, or the equipment being used.
2.    I acknowledge and agree to accept and assume any and all of the risks attendant to this activity. My child¹s participation in this activity is purely voluntary and I elect to participate not withstanding the risks.
3.    I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless CH from any and all claims, demands, or causes of action which are in any way connected with my child¹s participation in this activity or my use of CH equipment or facilities whether "on" or "off" the ice, including any claims which allege negligent acts or omissions on the part of CH.
4.    In the event CH, or anyone acting on their behalf, is required to incur attorney¹s fees and costs to enforce this agreement, I agree to indemnify and hold harmless for all such fees and costs.
5.    I certify that my child has adequate insurance coverage for any injury or damage I may cause or suffer while participating, and I agree to bear any and all costs of such injury or damage. I further certify that my child has no medical or physical conditions which could interfere with my safety in this activity, and I am willing to assume all risks and costs that may result, directly or indirectly, from any such condition.

By signing this document, I acknowledge that if anyone is hurt or property is damaged during my child¹s participation in this activity, I have waived my rights to maintain a lawsuit against CH.

I have had sufficient opportunity to read this entire document. I understand it and I agree to be bound by its terms.

 

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Participant¹s Name (Printed)

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Participant¹s Signature

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Parent¹s Signature

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Date

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