Summer Ice 2017 registration
SUMMER ICE 2017 ConocoPhillips/City of Kenai Multipurpose Facility
June through September 2017
PLAYER REGISTRATION Player’s LEGAL Name ____________________________________ Position __________ Date of Birth _______________
All players must be current registered USA Hockey members - go to www.usahockey.com USA Hockey member # __________________________ (nine digits and five characters) Parent Name(s) _____________________________________________________________ Zip code__________________ Cell Phone ___________________________ Parent’s email ___________________________________________________ Secondary Contact Name ___________________________________________ Cell Phone __________________________ Medical Condition(s) Instructors should be aware of: __________________________________________________________
Please check the box corresponding to the program you are signing up for and fill in division if it is requested: Program Weeks Amt Program Division Weeks Amt Cubs on Ice
(8)
$185
_________
3 on 3
________
(8)
$185
_________
Learn to Skate (8)
$185
_________
5 on 5
________
(8)
$185
_________
Men’s Elite
(8)
$185
_________
Power Skate ________
(8)
$185
_________
Rusty Blades
(8)
$185
_________
Power Skate ________
(16) $270
_________
Rusty Blades
(16) $270
_________
Skills
________
(8)
$185
_________
Women’s 101
(8)
$185
_________
Skills
________
(16) $270
_________
Women’s 101
(16) $270
_________
Defense Skills (8)
$345
_________
Forward Skills
(8)
$345
_________
Defense Skills (16) $540
_________
Forward Skills
(16) $540
_________
Summer Ice is an approved vendor for CONNECTIONS and IDEA
Sub total
____________
Please make checks payable to Red Line Sports
6% Tax
____________
Drop off at Red Line Sports or mail registration to: Red Line Sports 168 Trumpeter Avenue Soldotna, AK 99669
Total
____________
Contact Red Line Sports 283-4677 or Vince Redford 398-7570 for more information. Waiver of Liability / Hold Harmless Agreement: I am aware that hockey is a contact sport and that playing or practicing to play hockey will be an activity involving many risks of injury. I understand that the dangers and risks of playing or practicing to play hockey may include injuries ranging from minor sprains and contusions to major injury, possible paralysis, or even death. I understand also that the dangers and risks of playing or practicing to play hockey may result in not only injury, but also in serious impairment of my future abilities to earn a living; to engage in other business, social, and recreational activities; and to enjoy life generally. Having read and understood the above warning, I recognize the importance of following the coaches’ instructions regarding playing techniques and agree to follow such instructions. Having read the above warning and having understood the dangers and potential risks involved in playing or practicing in these programs, I give my consent as parent/legal guardian of player listed below to participate. Except for claims arising from the sole negligence or willful misconduct of the City of Kenai or Red Line Sports I hereby agree to hold the City of Kenai, Red Line Sports, their employees, representatives, and coaches harmless from any and all liability, actions, debts or claims of every kind whatsoever which may arise by or in connection with participation of my child/ward in activities related to the above mentioned City of Kenai/Red Line Sports programs. The terms hereof shall serve as a release for my heirs, estate executor, and all members of my family.
_______________________________________________________ Player Signature
______________________ Date
_______________________________________________________ Parent Signature
______________________ Date
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Debit/Credit Card must be presented at Red Line Sports in person to make payment. Name on card ____________________ Cash _________ Check # ________ Amt Pd _________ Date __________
June through September 2017
PLAYER REGISTRATION Player’s LEGAL Name ____________________________________ Position __________ Date of Birth _______________
All players must be current registered USA Hockey members - go to www.usahockey.com USA Hockey member # __________________________ (nine digits and five characters) Parent Name(s) _____________________________________________________________ Zip code__________________ Cell Phone ___________________________ Parent’s email ___________________________________________________ Secondary Contact Name ___________________________________________ Cell Phone __________________________ Medical Condition(s) Instructors should be aware of: __________________________________________________________
Please check the box corresponding to the program you are signing up for and fill in division if it is requested: Program Weeks Amt Program Division Weeks Amt Cubs on Ice
(8)
$185
_________
3 on 3
________
(8)
$185
_________
Learn to Skate (8)
$185
_________
5 on 5
________
(8)
$185
_________
Men’s Elite
(8)
$185
_________
Power Skate ________
(8)
$185
_________
Rusty Blades
(8)
$185
_________
Power Skate ________
(16) $270
_________
Rusty Blades
(16) $270
_________
Skills
________
(8)
$185
_________
Women’s 101
(8)
$185
_________
Skills
________
(16) $270
_________
Women’s 101
(16) $270
_________
Defense Skills (8)
$345
_________
Forward Skills
(8)
$345
_________
Defense Skills (16) $540
_________
Forward Skills
(16) $540
_________
Summer Ice is an approved vendor for CONNECTIONS and IDEA
Sub total
____________
Please make checks payable to Red Line Sports
6% Tax
____________
Drop off at Red Line Sports or mail registration to: Red Line Sports 168 Trumpeter Avenue Soldotna, AK 99669
Total
____________
Contact Red Line Sports 283-4677 or Vince Redford 398-7570 for more information. Waiver of Liability / Hold Harmless Agreement: I am aware that hockey is a contact sport and that playing or practicing to play hockey will be an activity involving many risks of injury. I understand that the dangers and risks of playing or practicing to play hockey may include injuries ranging from minor sprains and contusions to major injury, possible paralysis, or even death. I understand also that the dangers and risks of playing or practicing to play hockey may result in not only injury, but also in serious impairment of my future abilities to earn a living; to engage in other business, social, and recreational activities; and to enjoy life generally. Having read and understood the above warning, I recognize the importance of following the coaches’ instructions regarding playing techniques and agree to follow such instructions. Having read the above warning and having understood the dangers and potential risks involved in playing or practicing in these programs, I give my consent as parent/legal guardian of player listed below to participate. Except for claims arising from the sole negligence or willful misconduct of the City of Kenai or Red Line Sports I hereby agree to hold the City of Kenai, Red Line Sports, their employees, representatives, and coaches harmless from any and all liability, actions, debts or claims of every kind whatsoever which may arise by or in connection with participation of my child/ward in activities related to the above mentioned City of Kenai/Red Line Sports programs. The terms hereof shall serve as a release for my heirs, estate executor, and all members of my family.
_______________________________________________________ Player Signature
______________________ Date
_______________________________________________________ Parent Signature
______________________ Date
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Debit/Credit Card must be presented at Red Line Sports in person to make payment. Name on card ____________________ Cash _________ Check # ________ Amt Pd _________ Date __________
