Make checks or money order payable to:
David Roberts Hockey
1000 S. State St.
Ann Arbor, MI 48109-2201

Enrollment is limited.

David Roberts Youth Winter Hockey Clinic
When:	December 26th-29th, 2007 8-9:50am
Registration & Fees:	$149 for all four days Cash or check only please.
Classifications:	Mites, Squirts, Pee-Wees, Bantams (open to all ages)
Equipment:	Full hockey equipment required plus gym shoes.
Brochures and registration forms are available inside Yost Arena or by contacting  the Yost office at (734) 764-4600 or yostice@umich.edu
Home | Contact Us | Links | Yost Ice Arena

 

 

 

 

 

 

 

 

 

 

David Roberts Youth Winter Hockey Clinic

 

Name:_____________________________

Street Address:_______________________________________________________

City:_____________________ State:___________ Zipcode:___________________

Home Phone:(___)_____________________ E-mail:_________________________

Parent or Guardian's Name:_____________________________________________

Contact's Work or Daytime Phone Number:_________________________________

Emergency Phone Number: (___)_________________________________________

Age:________ Position:______________

Last Season's Division & Classification:_____________________________________

 

Cost is $149 (US Funds Only) Enrollment is limited!!! Please send (Check or Money order) payable to:

David Roberts Youth Hockey School 1000 South State Street

Ann Arbor, MI 48109

(734) 764-4600

AGREEMENT TO PARTICIPANT:

I/We agree to release Yost Ice Arena, David Roberts Youth Hockey Scchool, The University of Michigan, The University of Michigan Athletic Department and its employees from all claims, actions, causes of actions, or injury resulting directly from the participation of persons in the program. I further agree to indemnify and save harmless parties from all claims, damages or demands, including all costs and expenses incurred in defending any such claim or action.

I have read the release and understand that this is a full release of all claims for injury and damages sustained in Yost Ice Arena and have read over the agreement and understand the responsibilities I have assumed there under.

 

____________________________________ Particpant's Signature __________________Date

____________________________________ Parent or Legal Guardian's Signature _________________________ Date