Registration All August Camps 2023

Name

First

Last

Birthdate (mm-dd-yyyy)

2023/2024 Hockey Level

Address

Phone #

Email Address

Parents/Guardians Name

Please indicate any medical conditions, medications, or allergies:

Summer Camp (Female & Co-Ed Camps)

$365.00 GST Inc. if received by June 1/23
$410.00 GST Inc. if received after June 1/23
Week #2 August 14-17

Burn Camp: (Please select week/weeks for registration)

$135.00 GST Inc. if received by June 1/23
$180.00 GST Inc. if reveived after June 1/23
Week #1 August 8-11
Week #2 August 14-17
Week #3 & #4 August 21-24, 28-31 (combined weeks. 2 ice sessions/week)

STRIDES & Edge Works (Please select week/weeks for registration)

$135.00 GST Inc. if received by June 1/23
$180.00 GST Inc. if reveived after June 1/23
Week #1 August 8-11
Week #2 August 14-17
Week #3 & #4 August 21-24, 28-31 (combined weeks. 2 ice sessions/week)

Passing & Shooting (Please select week/weeks for registration)

$140.00 GST Inc. if received by June 1/23
$185.00 GST Inc. if reveived after June 1/23
Week #1 August 8-11 (please contact prior to registering for this week)
Week #2 August 14-17
Week #3 & #4 August 21-24, 28-31 (combined weeks. 2 ice sessions/week)

Small Group Technique Sessions

$295.00 GST Inc. if received by June 1/23
$340 GST Inc. if received after June 1/23
Week #1 August 8-11
Week #2 August 14-17 (Please contact prior to registering for this week)
Week #3 & #4 August 21-24, 28-31 (combined weeks. 2 ice sessions/week)

August Skating & Skills Camp

$205.00 GST Inc. if recieved by July 1/23
$250.00 GST Inc. if recieved after July 1/23
Week #3 & #4 August 21-24, 28-31 (combined weeks. 2 ice sessions/week)

Select your method of payment: By Clicking this box, I understand that I will be required to submit payment that is required for TJ Power Fit Camps. I understand that if payment is not made, the Registrant will not be accepted into the program.

Cheque- dated June 1, 2023
E-transfer- tjpowerfit2@gmail.com by June 1, 2023. Include security response
Cash

TJ Power Fit/Trisha Feil-Johnson 1221 Jubilee Drive Swift Current Sk. S9H 2A4

Total Amount

Cancellation Policy (please refer to individual camp brochures for full details)

No refunds after June 1/23. All refunds at discretion of TJ Power Fit

Notes (special requests or notes/reminders, please comment in box below)

DO NOT DESELECT CHECK BOXES IN Release of Liability, Waiver of Claims, Assumptionof Risks and Indemnity Agreement "RELEASE AGREEMENT"

Name/Photo Publishing

6. Should the participant be filmed for teaching purposes, or name/photo published for public display, a signature/ check box granting permission is required .

Release Agreement

In entering into this Release Agreement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of participating in Power Skating activities, other than what is set forth in this Release Agreement. I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS RELEASE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS RELEASE AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

Dated (Signed dd/mm/yyyy)

Printed name of Parent/Guardian

Acknowledgement

By checking this box, I confirm that I am the legal Parent/Guardian of the particpant registered in this TJ Power Fit Camp as printed above. I also agree that I have read this waiver, and that by submitting this online Registration Form, this waiver is binding.