• JBGK REGISTRATION FORM

  • Participant Information

  • Parent/Guardian Information

  •  -
  •  -
  • Emergency Information

  •  -
  •  -
  • Informed Consent and Acknowledgement

    I hereby give my approval for my child’s participation in any and all activities prepared by JBGK ACADEMY during the selected sessions. In exchange for the acceptance of said child’s candidacy by JBGK ACADEMY, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless JBGK ACADEMY, and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

    In case of injury to said child, I hereby waive all claims against JBGK ACADEMY, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including soccer. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

  • Confirmation

    BY ACKNOWLEDGING AND CLICKING SUBMIT BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  • All Bookings must be make at least 48 hours prior to the sessions.

    If you wish to cancel or change the date of a session you book please send an email to info@justinebernier.com. You can change your session with at least a 24 hour notice.

  • If you clicked one of the payment by cheque options or email transfer option, please send and email to info@justinebernier.com confirming which option you choose, for payment arrangements and scheduling Registration form must be filled and submited regardless. Your registration will only be considered valid after payment has been received and this form has been submitted.

     

    Thank You,

     

    Justine Bernier

     

     

     

  • Should be Empty: