2023 Summer Power Skating Registration (Top Shelf Hockey)

Print 2023 Summer Power Skating Registration
Player Info
  1. Players First Name
  2. Players Last Name
  3. RadDatePicker
    Open the calendar popup.
  4. Primary email to be used for communication
Parent / Guardian Info
  1. if different from above
  2. Example: ###-###-####
  3. Home, other parent, etc
Power Skating Info
7 Sessions Total - Tues Aug 22, Wed Aug 23, Thurs Aug 24, Mon Aug 28, Tues Aug 29, Wed Aug 30, Thurs Aug 31. SESSION 2 (5pm-6pm) is FULL
  1. Please be honest
Additional Info
Health Issues, Special Requests, etc.
  1. Health Issues, Special Requests, etc
If you prefer to pay by email money transfer, please submit this form and then send $249.00 (hst included) to [email protected]. Note: eTransfer only for Week 1 & Week 2 individual packages
  1. Proceed to PayPal payment page after submission
    Regardless of which method of payment you choose, you must submit this form to register for Top Shelf Hockey's Power Skating Clinic. After clicking the Submit Form button below, a copy of this form will be sent to the email address you provided above and a submission confirmation page will display.  

    - PayPal or Credit Card - From the submission confirmation page, you can click to pay online and you will be re-directed to our secure PayPal payment page. Follow the instructions on this screen to complete your payment. 

    - eTransfer -  Please send eTransfer payments to "[email protected]" and please include your child's name in the message section so we know who the payment is for.

    If you have missed any required fields, you will be taken to the field with missing information.
  2. 1.  I, being the parent or legal guardian of the child hereon registered, do authorize by checking below to permit TOP SHELF HOCKEY and their staff to seek out and obtain any necessary medical attention in the case of accident or injury during the program. It is further agreed that the operators of this hockey program are released from and all claims from damage that may arise from any accident, injury, death, damage or loss, which is caused by or arises from participation of the applicant hereon during the program or in any location where the program is being held.

    2.  TOP SHELF HOCKEY has my permission to use photographs, which may include my child, publicly for promotional purposes. I understand that these images may be used in print publications, the topshelfhockey.net website, and social media applications. I also understand that no royalty, fee or other compensation shall become payable to myself or my child by reason of such use.

Acknowledgements / Disclaimers / Notices
Human Validation