Elite Development Checking Clinic

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Registration

First and Last Name of Registrant *

Birth Year of Registrant *

2007

2008

Level Played During 2019/2020 Season *

AAA

Other

Emergency Contact Name *

Emergency Contact Phone Number *

Email Address *

I acknowledge that 9814558 Ltd., and its instructors, will not be held responsible or liable for any accident or loss, however caused, and agree to release 9814558 Canada Ltd.. and its instructors from all damages or claims which may arise as a result of such accident or loss. I hereby give my permission to seek out any medical assistance my child (or adult) may require while attending the program. Note: The person who agrees to this waiver must be at least 18 years of age. A parent must acknowledge for skaters under 18. Waiver must be acknowledged in order to be registered. *

I agree

Required

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