Lakeside Hockey Camp Registration

Thanks for joining us for camp. We can't wait to have your child join us!  

 

Please complete the form below

Parent's Name (Primary Contact) *
Parent's Name (Primary Contact)
Primary Contact Mobile Phone *
Primary Contact Mobile Phone
Please provide a primary cell number
Other Parent's Name
Other Parent's Name
Other Parent's Mobile Phone
Other Parent's Mobile Phone
Back Up Contact Name *
Back Up Contact Name
Please provide the name of a contact in case the parents can't be reached
Backup Contact Mobile Phone
Backup Contact Mobile Phone
Child's Name *
Child's Name
At what level has your child played
Release From Liability and Waiver *
I recognize that participation in this camp and this activity is potentially hazardous to the participant. I agree to indemnify and release Joe Rosenthal and his employees/assistants from any claims resulting from participation in the camp.