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Quick Reference Sheet
Quick Reference Sheet
Register for FloorBall
MCN SPORTS FLOORBALL (1)
PLAYERS NAME:
First
Last
DATE OF BIRTH:
*
LEVEL/AGE
PREVIOUS HOCKEY OR SIMILAR SPORT EXPERENICE:
Location Registering For Drayton Valley or Spruce Grove/Stony Plain
*
PARENT/GUARDIAN NAME:
*
MAILING ADDRESS:
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
EMAIL:
BEST PHONE NUMBER & NAME:
*
ALBERTA HEALTH CARE NUMBER:
ALTERNATE PHONE NUMBER & NAME:
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
Method of Payment: etransfer/Cash/Cheque to mgormanmcnadvising@gmail.com
*
Full payment of must be received at time of registration to guarantee spot. Cancellation/Refund Policy up to two weeks of first session refund of 100.00. 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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Quick Reference Sheet
Register
MCN SPORTS ADVISING & SKILL DEVELOPMENT
Registration Form
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
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Saint Martin
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
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: Cheque/E-Transfer -mgormanmcnadvising@gmail.com
Mastercard/Visa accepted additional charges apply.
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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