Registration – Private coaching in Quebec 1 Sponsors2 Player3 Parents4 Consent5 Selection EXTREME POWERSKATING AIMERAIT REMERCIER SES COMMANDITAIRES For all your real estate needs in Florida, please contact my wife Julie Murray First name of player*Last name of player*Player's email AgeSelect56789101112131415161718PositionPlease chooseForwardDefenceCalibre Father's full name*Mother's fullname*Primary email* Alternative email Phone number*CellphoneRefered byChoose oneRadioPrinted adFriend / familyOld studentOtherHousing*Please answerI am insterested in housing a studentI am not insterested in housing a student 18/02/2019 Ice Sports Forum, America's Finest Skating FacilityCentre Sportif Giffard Jonny Murray, Extreme Power Skating Camp & École de patin personnalisé de québec PARENTAL RELEASEPARENT/GUARDIAN RELEASE OF LIABILITY FOR A MINOR CHILD’S PARTICIPATION In consideration of my/our child of minor age, being allowed to participate in any way in the activities of the Ice Sports Forum, including Jonny Murray, Extreme Power Skating Camp and « École de patin personnalisé de québec » and any and all related events and activities, the undersigned(s) acknowledge(s), appreciate(s), and agree(s) that: 1. The risk of injury from the activities involved in these programs is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risk of serious injury to my/our child does exist; and, 2. I/WE (AS PARENTS OR GUARDIANS) KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERS, and assume full responsibility for any and all consequences of my child's participation and specifically assume all risks that may arise from any negligence of the releases; and 3. I/we (as parents or guardians) willingly agree to instruct my/our child to comply with the stated and customary terms and conditions for participation in this program, and any and all related events and activities. If I/we observe any unusual significant concern in my/our child's readiness for participation and/or in the program itself, I/we will remove my/our child from participation and bring such to the attention of the nearest official immediately; and, 4. I/we (as parents or guardians), for myself/ourselves and on behalf of my/our child, all of our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE ICE SPORTS FORUM and, its owners, officers, officials, directors, agents, employees, affiliates, and the representatives, as well as other participants in the program or at the facility, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors including Jonny Murray, Extreme Power Skating Camp and « École de patin personnalisé de québec » of the premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY incident to my/our child's involvement or participation in these programs, related events, and activities, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.Name of parent*Name of player*Required* I have read and understood the parental consent Number of classes 100$/classPlease choose1 : 100$2 : 200$3 : 300$4 : 400$5 : 500$6 : 600$7 (6 + 1 free) : 600$8 (7 + 1 free) : 700$9 (8 + 1 free) : 800$10 (9 + 1 free) : 900$11 (10 + 1 free) : 1000$12 (10 + 2 free) : 1000$Deposit to pay $ 0.00 CAD The amount due will be collected on the first day of your private classes Once your registration is received and completed, a member of EPS will contact one month prior to your private class to provide you with further information.