Osoyoos Junior Hockey Inc

2017 Main Camp Registration Form

Osoyoos Junior PLAYER’S SURNAME (PRINT): ______Hockey Inc. PLAYER’S FIRST NAME (PRINT): ______

PARENT’S NAMES: ______P.O. Box 99 Osoyoos, BC ADDRESS: ______CITY: ______Canada PROVINCE: ______POSTAL CODE: ______V0H 1V0 TELEPHONE (Home): ______- ______- ______(Cell): ______- ______- ______

FAX: ______- ______- ______Telephone (250) 495-6060 EMAIL: ______DATE OF BIRTH (DAY): ______(MONTH): ______(YEAR): ______

MEDICAL NUMBER: ______

Facsimile KNOWN MEDICAL ISSUES: ______(250) 495-6069 TEAM & DIVISION PLAYED FOR LAST YEAR: ______

POSITION: ______SHOOTS: ______HT: ______WT: ______

E-mail ALL CAMP FEES ARE PAYABLE TO Osoyoos Coyotes Junior Hockey Club: ken_law12@hotmail By Cheque, Money Order, Visa / Mastercard, E-Transfer. Please circle one. .com (250) 490-1788 Card #: ______Expiry Date: ______Name on Card: ______

Signature: ______Date: ______

Player Fee, Including Tax & Buffet Ticket: = $250.00 x ___ = _____ Optional Pasta Buffet Tickets for Family: $20.00 x ___ = _____ Total: = _____ REFUND POLICY: No refunds will be issued within 30 days of the camp, unless a signed medical certificate Proud Member of accompanies the request. All refunds are subject to a $125.00 administration fee.

CAMP REGISTRATION CLOSES AUGUST 17th, 2017 Regards, Ken Law Head Coach/GM (250) 490-1788 (cell) www.kijhl.com [email protected]

COYOTES 2017 MAIN CAMP WAIVER

Osoyoos Junior In consideration of the participant and his/her parent/guardian being Hockey Inc. permitted to register the participant in the Osoyoos Coyotes 2017 Main P.O. Box 99 Camp, we hereby forever release and discharge the Osoyoos Coyotes and Osoyoos, BC their owners, directors, agents, employees and any person or corporation Canada connected herewith from all matters of action, injury, damages, costs, V0H 1V0 claims or demands which we shall or may hereafter have, suffer or receive by reason of such participation in the camp.

The release shall be binding on our heirs, assigns, executors and Telephone (250) 495-6060 administrators. It is agreed that the Osoyoos Junior Hockey Inc. does not and shall not be considered to guarantee or warrant such equipment in the conduction of the said camp. It is further agreed that Osoyoos Hockey Inc. is not responsible for any lost hockey equipment. There are no exceptions. Facsimile (250) 495-6069 No refunds will be issued within 30 days of the camp date, unless a medical certificate accompanies this request. All refunds are subject to a $125.00 administration fee. Your signature below confirms that you have read and E-mail understand our waiver and the cancellation policy. ken_law12@hotmai l.com Signature of Applicant: (if over the age of 18) (250) 490-1788

Signature of Applicant’s Parent/Guardian: (if under the age of 19)

Proud Member of Ken Law Head Coach/GM (250) 490-1788 (cell) [email protected]

www.kijhl.com