Registration – Quebec city camp

1Players

2Parents

3Consent

4Payment

Player's first name*
Player's last name*
Player's bithday*
YYYY dash MM dash DD
Age*
Age the player will be on August 1st, 2023
Position*
Division
Team name
Hockey association
Level
Name of coach
Coach's email
Special needs

Father's full name*
Mother's full name*
Primary email*

Important information will be sent to this email.
Primary email confirmation*
Secondary email
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Primary phone number*
Cellphone
How did you hear about us

29/03/2023
Complexe Sportif Multidisciplinaire Ancienne Lorette
Aréna Bruno Verret St-Etienne
Jonny Murray, Martin Chouinard, Extreme Power Skating & École de patin personnalisé de québec

In consideration of my/our child of minor age, being allowed to participate in any way in the activities of the Complexe sportif multidisciplinaire de L’Ancienne-Lorette (CSMAL) or Aréna Bruno Verret St-Etienne (ABVSE), including Jonny Murray, Extreme Power Skating Camp, 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.
Full name of one parent*
Full name of player*
Required*
- I have read and understood the parental consent

Registration – Quebec city camp

Complexe Sportif Multidisciplinaire Ancienne LoretteAréna Bruno Verret St-EtienneJonny Murray, Martin Chouinard, Extreme Power Skating & École de patin personnalisé de québec

Complexe Sportif Multidisciplinaire Ancienne Lorette
Aréna Bruno Verret St-Etienne
Jonny Murray, Martin Chouinard, Extreme Power Skating & École de patin personnalisé de québec