Fun Hockey League Registration Form
NAME: ___________________________________________
DOB: __________________
STREET:_______________________________TOWN/STATE:________________________
PHONE:___________________________EMAIL:____________________________________
Please complete all required information then check off which program(s) you are registering for
Mondays
May 6, 13, 20 June 3, 17
Goalie Clinic
Tuesdays
6:30pm - 7:30pm
Player:
$99
Player:
Team:
$65
$550
Player:
Team:
$65
$550
Player:
Team:
May 10, 17, 24, 31 June 7, 14, 21
$65
$550
May 7, 14, 21, 28 June 4, 18
Girls U8/U10 Half Ice
Wednesdays
May 8, 15, 22, 29 June 5, 19
Mite Half Ice
Thursdays
Squirt Half Ice
Fridays
6:30pm - 7:30pm
6:00pm - 7:30pm
May 9, 16, 23, 30 June 6, 20
6:45pm - 8:15pm
Girls U12 Half Ice
6:40pm - 7:35pm
Girls U14 Half Ice
7:35pm - 8:30pm
Player:
Team:
Player:
Team:
$65
$550
$65
$550
Total Enclosed- $ _____________
Release of Liability
I am aware that the hazards of ice skating and ice hockey may include serious injury to bones, joints, ligaments,
muscles, tendons and other parts of the muscular skeletal system; and serious injury or impairment to organs and
other parts of my body, with impact on my health and general well being. In consideration of the Academy
permitting me to register for this program, I hereby voluntarily assume all risk associated with participation in this
program and agree to hold harmless the Academy, its agents, trustees, officers, and employees from any and all
liability, claims, causes of action or demands of any kind and any nature whatsoever which may arise from or in
conjunction with my child’s participation in this program, except in the event of gross negligence. The term of this
agreement shall serve as a release and assumption of risk for my child listed on this app lication. Also, if my
method of payment is by credit card, I hereby authorize Phillips Academy to charge my credit card in the amount
listed above.
Signature (Parent/Guardian if under 18)
Date
Fun Hockey
League
Sponsored by
Gunga Hockey
and Martian Sports Skills
Half-Ice Hockey League
Phillip Academy Ice Rinks
www.gungahockey.com
www.martiansportsskills.com
Spring Schedule
Mondays
Goalie Clinic
Tuesdays
U8/U10
Half Ice
Mite
Half Ice
Squirt
Half Ice
U12 Girls
Half Ice
U14 Girls
Half Ice
Wednesdays
Thursdays
Fridays
Teams can consist of:
6:30pm7:30pm
6:30pm7:30pm
6:00pm7:30pm
6:45pm8:15pm
6:40pm7:35pm
7:35pm8:30pm
5 Weeks
Player: $99
6 Weeks
Player: $65
Team: $550
Player: $65
Team:$550
Player: $65
Team:$550
Player: $65
Team:$550
Player: $65
Team:$550
6 Weeks
6 Weeks
7 Weeks
7 Weeks
Minimum: 10 players (goalie included)
Maximum: 12 players (goalie included)
etailed schedule and registration form on back