Registration

Winter 2010/2011 Program Information Coming Soon!

REGISTRATION

Registration Form

Please note that you will be redirected to the home page upon completion of this form. All applicants will receive an email within one (1) business day of submitting this form regarding confirmation of participation.

Applicant Information

Player Name:

Birthdate (d/m/y):

Address:

City:

Postal Code:

Parent Names:

Home Phone #:

Parent Cell #:

Parent Email:

Player AHC #:

Position:

Program:

Other:

Equipment:

Comments:

Conditions and Waiver/Release

NexXtep Skill Development reserves the right to alter or cancel programs at any time.
NexXtep Skill Development reserves the right to remove participants from the program with no refund.
No cancellations will be accepted after September 1, 2009 on which date full payment is due.

In consideration of the benefits conferred by acceptance of this application, we the undersigned agree to release, remise, hold and save harmless NexXtep Skill Development, their officers, members, servants, agents, instructors, supervisors and successors, from any and all claims whatsoever nature engaged in and all sports activities and kind, including bodily injury, death and property damage, sustained by us, or the above named player while engaged in and all sports activities, competitions, exhibitions, contests, and practices promoted by NexXtep Skill Development, or while traveling thereto or there from.

I accept the above conditions and waiver/release form