TAC Advanced Hockey

TAC Advanced Hockey
Holland Hockey Experience
Summer, 2008
Application and Waiver Form
(For Fax or Mailing)

Camp Information

Holland Ice Arena, Holland Michigan   ~   July 27, 2008 through August 2, 2008

Player Information

^Name:       ^{Birth Date:}

^Address: ^City: ^Zip:

^{Home Phone#:}        ^{Work
Phone#:}

^{Last Season Team:} ^Position:    ^Shot:

Payment Information:

Resident (No Housing or Meals) Non-Resident (Dorm & Meals Included)

^$525.00 ^(full)^$260.00 ^{(Deposit Only)} ^$695.00 ^(full)^$350.00 ^{(Deposit Only)}

^{Payment Method:}

^{Card/Check Number:} ^{Exp Date:}
^{(Note: a 3% Service Charge will be added for all Credit Card
Transactions)}

I acknowledge that ice hockey is a contact sport in which there are risks of injury, and that participants in a hockey clinic may make physical contact with the side boards, with other participants and with the ice. Knowing this, and desiring that the above-named minor may participate as a player in TAC Advanced.’s Holland Hockey Experience, and in consideration of his or her enrollment and participation in that Camp, I agree to indemnify and save the above TAC Advanced Hockey Camps (and including TAC Hockey, Inc. and/or Advanced Power Hockey), its director, instructors, agents and coaches, harmless from any and all liability for such claims for damages because of injury or otherwise sustained by the above-named minor, arising directly or indirectly out of or in connection with his or her enrollment and/or participation as a player in the Holland Hockey Experience presented by TAC Advanced.

*Signature: ___________________________________________
(*Must be signed by Parent or Legal Guardian)

Date: _______________ Print Name: _____________________________

Complete the above Application and Waiver
and send with a check payable to “TAC” to:

TAC Hockey, Inc.
6690 S. Route 53
Woodridge, IL 60517

Or Fax with Credit Card Information to (630) 521-1150