Registration:

Name of Team :
Name of Coach:
Name of Contact:
Address of Contact:
Phone:
Fax:
Email:
Age Group (Year):
Division: (House, A, AAA)
Comments:


                       

Disclaimer

The organizers of three on three and/or the arena shall not be held responsible for any accident or injury to participants, damage or loss of personal property, however caused whether on or off premises and shall be released from any and all claims. I certify that the applicants are in good physical and mental health and are able to participate in the activities of three on three challenge offers. In the event of an emergency I hereby give my permission to administer any life-saving medical procedures to be performed on the participants. I have read the above rules and sign in agreement.
Costs

600 Cdn or US * Cash / Cheque's Only. Paperwork and $ must be in by May 1, 2012

PLEASE SEND CHEQUES PAYABLE TO:
Al Stoddard
275 High Street
Fort Erie, ON L2A 3R4