Quick Reference Sheet – MCN Sports Shooting & Skill Development

SKATERS FIRST AND LAST NAME:

POSITION:

Level:

CAMP REGISTERING FOR:

DATE OF BIRTH:

PARENT/GUARDIAN NAME:

MAILING ADDRESS:

Street Address City State / Province / Region ZIP / Postal Code Country

EMAIL:

PHONE NUMBER & NAME:

ALTERNATE PHONE NUMBER & NAME:

SECOND CONTACT EMAIL:

ALLERGIES/PRE-EXISTING MEDICAL CONDITIONS:

I, THE PARENT/GUARDIAN OF THE ABOVE NAMED CHILD, HEREBY GIVE MY APPROVAL FOR HIS/HER PARTICIPATION IN THE ABOVE NAMED ACTIVITY DURING THE CURRENT SEASON. I ASSUME ALL RISKS INCIDENTAL TO THE CONDUCT OF THE ACTIVITY AND TRANSPORTATION TO AND FROM THE ACTIVITIES. I DO HEREBY RELEASE, ABSOLVE AND HOLD HARMLESS THE ORGANIZERS OF THE ACTIVITY, SPONSORS, SUPERVISORS, AND ANYONE CONNECTED WITH THE PROGRAM. IN CASE OF INJURY TO THE ABOVE NAMED CHILD, I HEREBY WAIVE ALL CLAIMS AGAINST THE ORGANIZERS AND SUPERVISORS OF THE ACTIVITY. I grant permission to MCN Sports and Matt Gorman to publish any and all publications for any lawful purpose including, without limitation, publicity, illustration, advertising, and Web content. I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS.

Parent/Guardian: Print and Sign:

Date:

Payment: Cash/Cheque/E-Transfer -mgormanmcnadvising@gmail.com

Full payment must be received at time of registration to guarantee spot. Cancellation/Refund Policy: Full refund is offered if cancelled on or before 6 weeks prior to camp minus $25.00. Any cancellations made after that time, will result in partial refund. We reserve the right to cancel any sessions if minimum registration numbers are not met. A fee of $25.00 will be charged for any NSF charges. Cheques payable to MCN Sports Advising.

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