Velenosi Power Skating & Hockey Development (Intake Form) - 2023 Full Day Hockey Camp Hamilton (Boys & Girls)

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MOHAWK 4 ICE CENTRE (QUAD PAD) -Drop off 8:30AM and Pick-UP BEFORE 4:00 P.M.

Group # 1 (2018/2017/2016/2015)
Group # 2 (2014/2013/2012)
Group #3(2011/2010/2009/2008)

Child's First Name:

Child's Last Name:

Date of Birth:

YYYY

Phone No.:

Cell No.:

Email Address:

Age:

Last Level:

Childs Jersey Size:

T-Shirt Size

Y/Small

Y/Medium

Y/Large

Y/XL

M/Small

M/Medium

M/Large

Clear selection

Last Velenosi Clinic:

Program Cost and Schedules:

For those students that attended the July 4th to July 7th summer camp program at the quad or the Resort Hockey Program at Sherkston Shores, you will receive a discount.

*The program will cost $452 (Including HST) if you bring your Velenosi 2023 hat and shirt.

** $452(Including HST) for more than one camp******PLEASE BRING HAT AND SHIRT THAT WAS PROVIDED.

*** $10 administrative fee will be added to all cc payment

Schedules and Pricing

July 4- 7 cost $389.85 (Including HST)if new to the 2023 summer camp, shirt and hat will be provided.

July 10- 14 cost $480.25 (Including HST) if new to the 2023 summer camp, shirt and hat will be provided.

July 17- 21 cost $480.25 (Inluding HST) if new to the 2023 summer camp, shirt and hat will be provided.

August 21- 25 cost $480.25 (Including HST) if new to the 2023 summer camp, shirt and hat will be provided.

August 28- 01 cost $480.25 (Inluding HST) if new to the 2023 summer camp, shirt and hat will be provided.

IMPORTANT INFORMATION:

*FOR QUESTIONS OR INFORMATION PLEASE EMAIL info@velenosihockey.com OR CHECK OUT OUR WEB SITE AT www.velenosihockey.com

*YOU WILL RECEIVE A SCHEDULE ON START-UP

*If your payment was deposited you are registered

*SKATERS MAY BE MOVED UP OR DOWN DEPENDING ON AGE/LEVEL AND ENROLLMENT

* Make-ups will only be made-up as long as there is availability in the Fall/Winter and cannot be carried over * Please email when your child will be away

*Classes and times could be changed depending on enrollment. Current VPS skaters may be moved up or down depending on age, level and evaluation. A payment plan is available.

*Please call the Mohawk 4 Ice Centre at 905-318-5111 for rink updates in case of bad weather or email info@velenosihockey.com

PAYMENT INFORMATION:

(Credit Card/Etransfer)

Credit Card Type:

Credt Card No.:

Expiry Date:

YYYY

Amount:

We now accept Etransfer: (Please make it to info@velenosihockey.com)

Name: (Name on etransfer)

Date Etransfer was emailed:

YYYY

CONSENT:

I give my consent to my child’s participation in all activities of the Velenosi power skating skills, hockey development, and resistance training (velenosihockey), and agree that the school and/or its proprietors, staff, directors and any other person or corporation connected herewith from all manner of action, injury, loss, damages, costs, however caused by participation in this program on or off the ice and agrees to release the proprietors, staff, directors and any other person or corporation from all claims or damages which as a result of or by reason by such accidents or loss. This release shall be binding on our heirs, spouses, assigns, executors and administrators. I understand that all participants must wear full CHA approved equipment.

CONSENT ANSWER: *

First Name

Last Name:

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