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Shoots: |
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Home Phone: |
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| Previous Team: |
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Date of Birth: |
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| Parent or Guardian Information: |
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| Cell: |
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| 2) First Name |
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| Waiver Agreement: |
I have read the Terms of Agreement Waiver and accept to all of its terms and conditions.
I accept: |
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Mail your payment and make check payable to:
Powershot Hockey Academy
12852 Wayne Road
Livonia, Michigan 48150
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Terms of Agreement Waiver
The applicant agrees that Power Shot Hockey will not be held responsible for any accident or loss however caused, and agrees to release the proprietors from all claims or damage which may arise as a result of such accidents or loss. In the event of the inability to contact me, I hereby give you permission to seek out any necessary medical assistance my child may require while attending the sessions. |