Sign-Up Players Name_________________________ Tri-Town Arena Address______________________________ City, State, Zip________________________ 311 W. River Road Phone_______________________________ Hooksett, NH 03106 E-mail_______________________________ Current Team_________________________ Hockey Level/Year_____________________ Hockey Experience____________________ ___________________________________ 20 16 Parents Name(s)______________________ Phone MANCHESTER MONARCHS Cell___________________________ PRE-PREP Work__________________________ DEVELOPMENT CAMP Email_______________________________ Jersey Size (circle one) Adult S M L XL ‘98, ‘99, ‘00, ‘01 Medical Release For More Information: July 18-22 I acknowledge that the applicant is in good health and is able to par- ticipate in the physical activities of the sport of ice hockey. In the event my child is injured during absence of parent or legal guardian, I give Contact Jeff Giuliano my permission for the person in charge to seek medical attention.
[email protected] Tri-Town Arena Release of Liability Upon entering the Manchester Monarchs Hockey Camp, I/we under- (603) 801-0208 stand that participation in the sport of ice hockey, as well as this camp, Hooksett, NH constitutes a risk to me/us of serious injury, including permanent per- alysis or death. I/We voluntarily and knowlingly recognize, accept and assume this risk and release the Monarchs/Jeff Giuliano, its sponsors, staff members, the skating facility and officials from any liability. Signature _____________________________________ Only 15 spots Date _____________________________________ available SIGN UP Make checks payable to Manchester Monarchs per group Return Form & Payment to NOW! Jeff Giuliano 555 Elm St. HOSTED Manchester Monarchs & Manchester, NH 03101 BY: Jeff Giuliano Schedule Pricing Coaching Staff Jeff Giuliano #1 - Team A (15 Players) $399 per skater Manchester Monarchs Assistant Coach, Jeff Giuliano, played six seasons for the Monarchs from 2002-2008.