14-18 Muskoka Hockey Elite Academy July

14-18 Muskoka Hockey Elite Academy July

FOR ELITE MALE & FEMALE PLAYERS | AA-AAA, JUNIOR, OHL, NCAA
Player Full Name*

First NameLast Name
Player Sex
Player Date of Birth*

MonthDayYear
Date
Do you require local accommodations to participate in the Muskoka Hockey Elite Academy?*
Accommodations are limited, we will contact you directly regarding pricing and availability.
Player Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Player Position

ForwardDefenceGoalie
Player Current Team*

Parent / Guardian Name*

First NameLast Name
Parent / Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Email*
example@example.com
Parent / Guardian Emergency Contact Phone Number*

Area CodePhone Number

Please review and sign the following waivers

Parental Consent and Liability Waiver

Muskoka Hockey Group will not be responsible for ensuring that the participants of any activities have the requisite skill, are provided any necessary supervision by responsible persons and that all individual safety requirements are observed by participants. Without assuming any liability, and in the interests of safety, in the case of any use of any of these special facilities at Rosseau Lake College, Muskoka Woods, & Humphrey Arena. Muskoka Hockey Group reserves the right, through any of its responsible employees, to insist upon all appropriate safety rules and procedures being observed and upon any degree of supervision it considers advisable being provided by the Hockey Team, and to limit or terminate the use of any such special facilities as it may consider advisable.In the event that a child requires medication, X-ray, or treatment beyond that which is possible at Muskoka Hockey Group, the parent / guardian will be charged with the additional expense of transportation and special care. It is the responsibility of the Hockey Team to notify the affected guest’s family. The undersigned authorizes the administration of any first aid treatment necessary at Muskoka Hockey Camp, and in the case of medical emergency, give permission to the Physician selected by the Muskoka Hockey or sponsors to hospitalize and secure proper treatment for the undersigned as named below. Every effort will be made to contact parents or guardians before such action. The undersigned grants permission to Muskoka Hockey Group and to any third party authorized by Muskoka Hockey Group to use photos, videos or any other recording or reproduction of the undersigned in any medium for use in promotional materials and/or as otherwise seen fit by Muskoka Hockey Group. For valuable consideration, the receipt of which is hereby acknowledged, the undersigned hereby releases and forever discharges Muskoka Hockey Group and their respective members, agents, volunteers, employees, officers and directors (the "Releasees") from any and all actions, causes of action, claims and demands resulting from any loss, injury or damage to person or property which has arisen or may arise from any and all use of the Muskoka Hockey Group including any programs or otherwise, unless any such loss, injury or damage may have arisen by reason of the negligence of the Releasees. The undersigned agrees that any and all actions arising out of this agreement or the use of the Muskoka Hockey Group will be governed by the laws of Ontario, Canada and consents to the exclusive jurisdiction of the courts in Ontario, Canada in any and all such actions.
Name of Player Participant*

First NameLast Name
Date*

MonthDayYear
Date
Name of Consenting Parent / Guardian*

First NameLast Name
Signature of Parent / Guardian*

Clear

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

14-18 Muskoka Hockey Elite Academy July

Child Medical Form