Prospects Registration Form
Please fill out the form in it's entirety and check off the waiver below.
If you receive an error message or have any technical difficulties completing this form,
try it using FIREFOX instead of IExplorer or please call us 1-888-824-1534
Once you click "Submit" you will be directed to the payment page where you can secure your registration with a deposit.
| First Name: * |
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| Last Name: * |
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| Parents Name(s): * |
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| Address: * |
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| City: * |
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Postal/Zip Code
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| Phone: * |
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| Email: * |
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| Date of Birth (DD/MM/YY): * |
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| Height/Weight: * |
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| Position: * |
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| Current Team: * |
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Coaches Name
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| Coaches Phone: * |
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| Camp Location: * |
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1. By checking the box below, I, being the father, mother or guardian of the registrant, an infant under the age of 18 years, hereby consent to the Participant, becoming a member of the Accel Hockey Program and Participating in the Accel Hockey program activities and, on behalf of the said Participant, hereby assumes all risks of personal injury or damage which may result from any activities of the Accel Hockey program.
2. By checking the box below, on behalf of the Participant, I hereby waive any claims to which he/she may become entitled for injury or damage and release the Accel Hockey Program, all of the Accel Hockey Program officials, officers, directors, staff, owners, organizers, representatives, their agents or employees of any ice facility used by Accel Hockey Programs liable for injury or damage which the Participant may sustain while participating in any Accel Hockey Program activity.
3. By Checking the box below, I acknowledge on behalf of the Participant that the sport of hockey has physical dangers, which may result in serious injury or death. In the event of emergency, I hereby give my permission to administer any medical procedures to save the participants life.
4. The Participant is advised to carry medical insurance.
5. By checking the box below, on behalf of the participant certify that the participant has no known medical condition which would prohibit him/her from playing he sport of ice hockey and state that the participant is in proper physical condition to play the said sport and that he/she is the age of majority.
6. By checking the box below, I understand that there will be no refunds. If a participant is unable to take part in a program due to medical reasons or for any other reason, he/she will receive a credit toward any future Accel Hockey Programs. Credit is not valid for products or other services offers by Accel Hockey. Payment totals are subject to HST, GST and/or processing service charges. A $40 Service Charge applies to all NSF cheques.
7. By checking the box below, I will see to it that the participant wears the specified equipment set out in the Accel Program rules.
8. By checking the box below, I will see to it that the participant will act in a responsible manner in all the Accel Hockey Program activities.
9. By checking the box below, I agree to reimburse the Accel Hockey Program in full within 5 days of notice, for the cost of any property damage for which the player is held responsible by the Accel Hockey Program staff or owners.
10. By checking the box below, I acknowledge on behalf of the Participant that the Accel Hockey Program policy is no reimbursement to any participant.
11 The Accel Hockey Program Manager has final authority as to what levels, divisions or teams the player will participate.
12. By checking the box below, on behalf of the Participant, I understand and agree that the Participant may be expelled from the Accel Hockey Program for any of the following reasons:
a) Financial delinquency. b) Failure to abide by all Accel Hockey Program rules. c) Falsification of registration information
13. By checking the box below, I grant Accel Hockey permission to take photographs and video the student and to use them for commercial purposes within the law and without payment of any kind to the participant, parent or guardian.
14. By checking the box below, I grant permission to Accel Hockey to offer additional products and/or services to the participant as it relates to training and development.
15. By checking the box below, I acknowledge that I have read and understood the terms and conditions of this application and agree to abide by the terms and conditions.
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Check this box to agree to terms |
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