Thanks for expressing interest in Steve Serdachny's Edge Power Skating and Hockey International. If you have any problems, questions or concerns regarding this order form please call 1-877-30-SKATE or (International) +1(780) 465-3343 or email us at edge@elitepowerskating.com

FAX 780-440-2921

MAIL
Elite Power Skating & Hockey Schools International
734 Hendra Cr.
Edmonton, AB, Canada
T6R 1S6

 

Camp to Register For:  
   
First Name:  
Last Name:  
Sex:  
Email Address:  
Address:  
City:  
State / Province:  
Postal Code / Zip:  
Phone Number:  
Level of Play:  
   
[ yes ]  [ no ] $95 Purchase Video Stride Analysis. NOTE: Video Stride Analysis is available for camps in Edmonton ONLY.
[ yes ]  [ no ] $30 Purchase Registration Insurance
   
Shoots/Level/Pos:  
Date of Birth:  
Weight:  
Parent/Guardian:  
Emergency Phone:  
 
If student has any allergies or medical conditions, please specify:


 
 
If you have any questions, please specify:

 

In Consideration of Steve Serdachny's Edge Power Skating & Hockey International and/or Steve Serdachny Consulting Inc. and/or Steve Serdachny
Power Skating & Hockey USA accepting re rew as a participant in their skating and hockey programs, I ____________________ hereby for myself, my heirs, executors, administrators and assigns, forever release and discharge Steve Serdachny's Edge Power Skating and Hockey International and/or Steve Serdachny's Consulting Inc. Their Instructors, Administrators, servants, agents, sponsors, employees or volunteers from any claims, demands, costs (including solicitor and client costs on a full indemnity basis) actions, causes of action, proceedings arising out of or as a consequence of any loss, injury or damage however caused by attending and participating in Steve Serdachny's edge power skating and hockey international and/or Steve Serdachny Consulting Inc. programs.

I declare that re ____________________'s
physical condition, to the best of my knowledge, is such that it will enable him/her to participate safely in all skating and hockey related programs and that no physician or other qualified individual as advised him/her against participating in this or similar programs and further assume all responsibility with him/her not obtaining such an examination. We reserve the right to cancel with 100% refund any session due to circumstances that are not to the benefit of the participants and/or the camp. Final grouping of the players will be at the administration's discretion. The sport of hockey, skating and dryland sporting activities has inherent physical risks that may result in serious damage/personal injury. The participant knowingly and freely assumes all risks. Medical insurance is the full responsibility of the participants.

I also understand that:

- Full protective equipment including helmet must be worn.
- The administration reserves the right to remove from camp any participant if in the opinion of the instructors or administrators the participant is not acting in an acceptable manner.
- Steve Serdachny's Edge Power Skating & Hockey International and/or Steve Serdachny Consulting Inc. reserve the right to cancel with 100% refund any session due to circumstances that are not to the benefit of the participants and/or the camp. Final grouping of the players will be at the
administration's discretion. The sport of hockey, skating and dry land sporting activities has inherent risks that may result in serious damage/
personal injury. I knowingly and freely assume all risks. Medical insurance is the full responsibility of the participants.
- No refunds will be made. Participants may fill his/her spot if unable to attend. Note: A $50.00 administration fee will be charged to any class
transfers or changes.
- Cameras, videos & note taking are prohibited. All curriculum is the sole property of Steve Serdachny Consulting Inc. Any copying in whole or in
part is prohibited by the rights holder without written permission.
- A $50 fee will be charged for all N.S.F. cheques and class transfers. By signing your accepting our privacy policy found at
www.elitepowerskating.com/privacy.asp
- You also consent to receiving future camp and school information
electronically.
- Due to some circumstances beyond our control we reserve the right to adjust camp facilities and/or camp times.
- Photos and videos taken during the camps may be used for promotional purposes. Steve Serdachny's Consulting Inc. reserves the right to reassign
the player/student into different groups or adjust &and combine groups as deemed necessary.



Signature:


_____________________________________________________________

Parent/Guardian