Steve Knuble's Hockey Skills Clinic

 

"The Perfect Clinic for Beginning Men and Women Hockey Players"

REGISTRATION FORM

NAME____________________________________________

ADDRESS_________________________________________

CITY__________________STATE_______ZIP___________

PHONE___________________________________________

EMAIL___________________________________________


ADULT  EVENING SESSION
THURSDAYS (see schedule)
ANN ARBOR ICE CUBE
$290


______ MAY 22nd - AUGUST 28th



LIABILITY WAIVER

I agree to release Steven Knuble, Michael Knuble, Bill Ellsworth, Assistant Instructors, Ann Arbor Ice Cube, and West Shore Ice Arena from all claims, actions, causes of actions and damages by the undersigned person for the loss or injury resulting directly or indirectly from the participation of such person in this hockey clinic. I further agree to indemnify and save harmless such parties from all claims, actions, damages or demands, including all costs and expenses incurred in defending any such claims or actions.
I fully recognize that participation in the sport of ice hockey can be hazardous, even dangerous, and can result in minor or serious injury, even death. I have fully read this waiver and I acknowledge a complete understanding of the contents of said waiver.

SIGNED____________________________________________
(Participant/Parent or Guardian)

DATE_____________________________

Please make checks payable to Bill Ellsworth
and send with signed registration form to:
Bill Ellsworth
4101 Kinfolk Ct.
Pinckney, MI 48169