Youth Basketball Clinic on December 16, 2018

Register for Youth Hockey and Learn to Skate Clinic

Join the Pomfret School Girl’s JV Hockey Team for a youth ice hockey and learn to skate clinic!!! *Please note, there are no rental skates available, so be sure to bring your own!
Child's Name*

First NameLast Name
Age of Child*
Gender*
Which clinic will your child participate in?*

Learn to SkateYouth Hockey
Does your child have previous experience?
If so, to what level?

Primary Parent/Guardian Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
Cell Phone*

Area CodePhone Number
Secondary Parent/Guardian Information

Optional
Full Name

First NameLast Name
Cell Number

Area CodePhone Number
Any medical conditions or allergies?
Additional Comments:
By submitting this form, I agree to the following:

I hereby release Northeast Opportunities for Wellness, Inc. (NOW) and Pomfret School from any and all claims of liability, personal injury or property damage arising from participation in this program. I understand that participation in sports involves some element of physical contact and I certify that my child is in good health and able to participate in all activities. If any attention is required for illness or injury, I give my permission to NOW & Pomfret School staff member(s) for such care. I give consent for my child to be photographed or videotaped during the program and release use of the images by NOW for promotional purposes.
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Register for Youth Hockey and Learn to Skate Clinic