2008 Summer Sessions application
Please fill out completely or the form will be rejected by our system.
* Required Fields
Program  
*Skater First Name  
*Skater Last Name
*Names of Both Parents:  
*E-mail address (parent):  
*Telephone (Home):  10 digits, must have dashes
*Telephone (Business):  10 digits, must have dashes
*Street Address:  
*City:  
*State:  
*Zip:  
*Position:
*Birth Date:   Ex. 02/23/1994
*Present Age:  
Notes/Questions
(255 characters)
Previous Hockey Experience: 
(255 characters)		  
 

 I, as parent of the above named player, agree, by both checking the box below and by my signature on my check remitted for the 2007 summer sessions, for myself and my daughter that the Connecticut Polar Bears Women's Hockey Club, Inc., and its agents, servants, and employees, shall in no way be responsible or liable for any injury of any kind to my daughter, arising out of or in the course of any operations of said hockey club. It is my intention to waive and release any and all claims of any kind whatsoever, in law or in equity of my enrolled daughter, in her own right and as guardian of my daughter, a minor, on account of any injury of any kind arising out of or in the course of any operations of said hockey club. Also, it is agreed that any equipment which the Connecticut Polar Bears may use in conducting the tryouts is not guaranteed or warranted in any fashion.

This is a general release of all claims. This release is given in consideration of my daughter being allowed to participate in a Connecticut Polar Bears skating program.

I indicate my consent to the above by checking the following box:
I accept the above terms, 

* Required Field