WINTER Skating Programs Reg Form 2009-10 by skateguy


									         CHURCH ATHLETIC LEAGUE OF KINGSTON                                                                                          Office Use Only
                Harold Harvey Arena, 42 Church Street, Kingston, Ontario, K7M 1H3                                           Learn to Skate Winter
                            tel: 613-542-1362 fax: 613-542-3345                                                             Power Skating Winter/Level
                 website: email:


                            Winter Skating Programs – Sun. Jan. 10 to Sun. Mar. 7, 2010
                                                      Fee: $145.00 for nine sessions

Player___________________________________ / _________________________________                      Date of Birth: ______/______/______         MALE/FEMALE
                       last name                                 full first name                                     day    month     year

Address ______________________________________________________ ________ _____________________________                                   __________________
            #                        street                                          apt                     city                             postal code

Father _______________________________________________ □ Primary Mother ____________________________________________□ Primary
                                                         Contact                                                      Contact

Tel: (H) _____________________ (W) ____________________                            Tel: (H) _____________________ (W) ___________________

email _______________________________________________                              email ______________________________________________
          *receipts will be sent via email where possible                                        *receipts will be sent via email where possible

Emergency Contact ____________________________________                             Tel: __________________________

                               Choose one of the sessions below:

                                   Learn to Skate Winter (age 5+)                          noon – 12:50 pm
                                   Nov/Minor Atom Power Skate                          1:00 – 1:50 pm
                                   Major Atom Plus Power Skate                         2:00 – 2:50 pm

To register your child for a winter 2010 skating program, complete this form & mail or deliver it with full payment to the
CAL office, Harold Harvey Arena, 42 Church Street, Kingston, ON, K7M 1H3. Payment by cheque or cash may be made
at the CAL office during office hours. The CAL office is not able to accept payment by credit card or debit.

 Consent: My child and I agree that the directors, team officials, committees, employees and instructors of the Church Athletic League are released
 from any and all claims of damage or loss as a result of injury which may arise from participation of the applicant in Church Athletic League programs.
 My child and I agree to participate in the activities of the Church Athletic League under its rules and regulations and the aforementioned conditions.
 Refund Policy: Refund requests must be made in writing (letter or email) to the Church Athletic League office, detailing the reason for withdrawal. If
 granted, the refund will be pro-rated based on the number of sessions having occurred since the start of the program and the date request is received.
 Hockey Canada insurance and registration fees are non-refundable. An administration fee of between $25.00 and $50.00 will be deducted.
 Payment Policy: All skating programs must be paid for in-full at time of registration unless alternative payment has been arranged.

___________________________________________________________________________                                          _________________________
Signature of parent/guardian or Players 18 and over (registration not valid without signature)                               Date

 Office Use only
 Date Received _______________________                Time _________         Amount _______________                 Registrar Initials_______________

  Cash          Cheques    Dated ____________ Amount ____________ Paid by _________________________________________(name on chq)

dec 09

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