Fillable 2022 SUMMER RINGETTE CAMP REGISTRATION FORM (University Ringette)

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2022 SUMMER RINGETTE CAMP REGISTRATION FORM (University Ringette)

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The 2022 SUMMER RINGETTE CAMP REGISTRATION FORM (University Ringette) form is 4 pages long and contains:

  • 3 signatures
  • 27 check-boxes
  • 45 other fields

Country of origin: CANADA
File type: PDF

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2022 SUMMER RINGETTE CAMP REGISTRATION FORM
Three Different Ways to Register:
By Mail: Friends of Ringette Society
Box 3148
Ft. Saskatchewan, Alberta T8L 2T1
By Fax: 780-998-0425
By E-mail: Attach your completed camp registration form and email it to
UniversityRingette@gmail.com
**Please Note: registrations are processed on a first come, first
served basis. Incomplete registration forms will not be processed.**
Please Provide Us With the Following Important Information:
Child’s Last Name Child’s First Name
Parent/Guardian’s Name
Mailing Address
City Province Postal Code
Home Phone # Business Phone #
Cell Phone #
_______________________________________________________________
E-mail Address: camp info will be sent here
Current Age Date of Birth Gender
(dd/mm/yy)
Details of any Medical Conditions:
Emergency Contact Name Phone Number
Indicate level of Ringette Played During 21/22 Season:
Active Start 1-2 U10 Step 1 U10 Step 2 U10 Step 3
U12 U14 U16
AA A B C
Defense Forward Centre Goalie
Total number of years of ringette played ___________
Select Camp Jersey Desired:
Note these are adult sizes
XS S M L XL
Select Camp Location & Age Group Desired:
Please check both a camp location and an age group)
___ August 8 – 12, Leduc, Leduc Recreation Centre
___ August 15 – 19, St. Albert, Servus Place
___ August 22 – 26, Sherwood Park, Millennium Place
___ U10 Step 2
___ U10 Step 3
___ U12
___ U14/U16
___ Goaltending instruction requested
Have you previously attended a University Ringette Camp? Yes ___ No___
If yes, please provide details of camp(s) attended (i.e. when, where, age
group, etc.)
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
2022 Ringette Camp Fees $450.00 (includes all taxes & fees)
Please indicate your method of payment:
___ Cheque/Money Order (payable to: Friends of Ringette Society)
___ E-transfer to UniversityRingette@gmail.com (security answer: your child's first name)
___ Visa or MasterCard
___ Original copy of UR Camp certificate attached
Card number: ______________________________________
Three digit CSV number on back of card: _______________
Expiry date: ________________________________________
Signature: _________________________________________
Full payment must accompany your registration form in order for it to be
considered complete and processed. In no event will camp placements
occur prior to full payment being received.
Cancellation Policy:
All cancellation requests must be submitted in writing.
The following conditions apply:
• Full refund of fees paid, less $100.00 administration fee, for
cancellations received more than 19 days prior to start of camp.
• 50% refund of fees paid for cancellations received less than 20
days prior to start of camp
• No refund if injury or illness occurs after the camp has started.
• No refund for no-shows.
Within three (3) weeks of receiving your camp registration form
we will send you an email with further details. Please be patient
and refrain from calling us simply to check on the status of your
registration.
If you have questions, call us at 780-998-5011 and ask for Bonnie.
Please ensure you complete the consent form on the next
page. Without it your summer camp registration form will
be considered incomplete and will not be processed.
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signature
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2022 Summer Ringette Camp Consent Form
Please provide the necessary initials in the spaces provided below
As a condition of registration PARTICIPANT and PARENT/GUARDIAN agree:
1. To be solely responsible for any personal property lost and any injury, loss or damage
sustained unless such injury, loss or damage was caused by the sole negligence of
summer ringette camp staff.
Initials (participant) _____ (parent /guardian) _____
2. That the participant and parent/guardian understand, appreciate and accept the
inherent physical risks of summer ringette camp activities.
Initials (participant) _____ (parent /guardian) _____
3. That the participant has recently seen a licenced medical practitioner and to the best
of my/our knowledge is physically and mentally able to participate in all activities of the
summer ringette camp.
Initials (participant) _____ (parent /guardian) _____
4. That the participant will wear full protective equipment required by the sport
(including shoulder pads) and that the equipment brought to the camp will meet or
exceed all minimum CSA and/or Ringette Canada standards.
Initials (participant) _____ (parent /guardian) _____
5. Should the participant be injured during the camp I/we give permission for summer
ringette camp staff to provide emergency medical treatment.
Initials (participant) _____ (parent /guardian) _____
The summer ringette camp coordinator reserves the right to assign the participant to a
group most appropriate for their age and ability; and to request any participant withdraw
from the camp if the participant is not acting in an appropriate and responsible manner;
and to cancel any camp with a 100% refund of registration fees.
I have read and understand all the terms of this legal agreement. By voluntarily signing
this agreement I am agreeing to abide by its terms and conditions. I understand it is
binding on me, as well as my heirs, next of kin, executors, administrators, assigns and
representatives, in the event of my death or incapacity.
Signed this _________day of_______________2022, at__________________________
Signature of Camp Participant ______________________________________________
Signature of Parent/Guardian ______________________________________________
Printed name of Parent/Guardian ____________________________________________
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UniversityRingette@gmail.com
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2022 SUMMER RINGETTE CAMP REGISTRATION FORM (University Ringette)

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Completed 17 January 2022

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