Registration Form

Summer Skills Clinic
Stay in shape and keep your game season-ready at the Summer Skills Development Clinic. This clinic features 14 high intensity on-ice sessions focusing on all areas of skill development. Students will participate in both full ice and small area drills that will further develop their skating and stick skills. Space is limited to 20 skaters. Payment is due upon registration.

Please contact Kevin directly with any questions at:
(516) 848-4374 or
kevin@kevinsmithhockey.com

Dates:
July: 7, 9, 14, 16, 28, 30
August: 4, 6, 11, 13, 18, 20, 25, 27

Time: 7:30am - 8:45am
Ages: Students in grades 9-12 for the 2026/2027 school year
Location: Port Washington Family Skating Center
Cost: $750 or $65 persession

Choose the sessions you will be attending or choose ALL for all sessions

Players Name

First NameLast Name

Position

Date of Birth

Date

Address

Street Address

Street Address Line 2

CityState

Zip Code

Parent or Guardian Name

First NameLast Name

E-mail

example@example.com

Phone Number

Format: (000) 000-0000.

By signing and submitting this form I agree to the following waiver:

I hereby give permission for my child to participate in the Kevin Smith Summer Hockey Clinic and agree to comply with all program regulations. I hereby release Kevin Smith Hockey, Port Washington Family Skating Center and the staff and management of both from any and all responsibility for bodily injury, property damage or theft of personal property that may occur while involved in this program on or off the ice surface

Signature for waiver