Velenosi Power Skating & Hockey Development      (Intake Form)  - 2024-25 Fall/Winter Clinic 

2024-25 Fall/Winter Program

Power-skating, stick handling, shooting, and puck control.

Boys and Girls (Ages 9 to 15)
8 Week Program or 16 Week Program

Every Tuesday- Starting on Tuesday, October 22nd at 6:30 p.m. to 7:30 p.m. 

Location: MOHAWK 4 ICE CENTRE (QUAD PAD)

*We accept Walk-ons as long as we have availability, please contact Judy at info@velenosihockey.com prior to the date. The cost will be 60.00 each time by e-transfer only. Please make payment before your child goes on the ice.

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Program Cost and Schedules:

*The 8 week program will cost $385.00 (plus HST)includes jersey

* Save $20 when booking the 16 week program $725 (plus HST )includes jersey

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

Please note that Velenosi Hockey Development does not issue any refunds. 

Please select your preference in weeks: *
Child's First Name: *
Child's Last Name:
Date of Birth: *
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Home No.:
Cell No.: 
Email Address: *
Last Level: 
Childs Jersey Size:
Last Velenosi Clinic:
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)
We now accept Etransfer: (Please make it to info@velenosihockey.com)
IF PAYING VIA E-TRANSFER PLEASE FILL OUT THE BELOW FIELD "NAME ON ETRANSFER)!!
Method of payment: *
Credit Card Type:
Credt Card No.:
Expiry Date: 
Amount: 
Name: (Name on etransfer)
Date Etransfer was emailed:
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DD
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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: *
Parent/Guardian First Name:
Parent/Guardian Last Name:
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