Camps & Tryouts

We look forward to meeting you!

Participation Form for Tryouts, AP Opportunties, PD Day or Summer Camps

Player Information

* Indicates required field

Student (Player) Name *

First

Last

Select One *

Player Birth Year *

player Hockey Position *

player Current Hockey Team *

Gender *

Male Female

Parent & Health Information

Parent Name *

First

Last

Parent Email *

Parent Cell # *

Please let us know of any allergies or health concerns for the player that you'd like us to be aware of. *

Secondary Emergency Phone Number *

Secondary Emergency Name *

First

Last

Authorization, Release and Indemnity
I/we understand and acknowledge that the staff, officers, employees and agents of A21 Academy act in the place and position of guardian of my child(ren) while in attendance at A21 Academy. Recognizing this, I/we authorize each or any of them to provide to my child(ren) any medical treatment and support that they consider to be reasonable or necessary.
In consideration of their willingness to care for my child(ren), I/we release, remise and discharge, indemnify and save harmless, the A21 Academy Ltd, its Board of Directors, officers, employees and agents from any and all liability, claims or causes of action by virtue of application, or non-application of medical treatment and not liable for any accident or loss however caused. I/we agree to release A21 Academy from all claims and damages.

Please click to confirm you have read the A21 indemnity clause above: *

I confirm I have read and agree

Submit

Location:
WFCU Centre
8787 McHugh Street
Windsor, Ontario Canada
N8S 0A1

We look forward to meeting you!

Participation Form for Tryouts, AP Opportunties, PD Day or Summer Camps

Player Information

Parent & Health Information

A21 ALUMNI COMMITS