Renegades Selects 2012

Renegades Spring Elite Selects

Identification Skate

$90 for tryout fee @ MENNEN ARENA

March 5, Monday - Mennen 1
5:30pm - 6:30pm - 2004/2005
6:45pm - 7:45pm - 2003/2000
8pm - 9pm - 2002/2001
March 11, Sunday - Mennen 3
4:30pm - 5:30pm - 2004/2005
5:45pm - 6:45pm - 2003/2000
7pm - 8pm - 2002/2000
1999, 1998, 1997 - teams are by invite, if you are interested please contact Noel Rubin.
All players attending the Identification Skates must have a written release from thier current in-season Club’s authorized representative.

View this form as image

APPLICATION

Player Name:

Age:

Birth Date:
(mm/dd/yyyy)

Parent First Name:

Parent Last Name:

Address:

City:

State:

Zip:

Email:

Home Tel:
(no dashes)

Cell Phone:
(no dashes)

USA Hockey Reg. #:

Indicate birth year team you're participating on:
(yyyy)

Position:

'11-'12 Team & Level:

Jersey Size: (please select one)

Youth

Medium
Large/X-Large

Mens

Small
Medium
Large

Gear Sizes:

Desired Number:
Please have three choices, returning players will have first preference

Emergency Contact Person:

Emergency Contact Tel:
(no dashes)

PAYMENT:

Due at registration, 100% of total tuition for clinics, 50% of total tuition for camps (remainder due by 5/16/12)

Spring season cost is $1,175 for Tier I and $899 for Tier II. Tier 1-15 practices and 3 tournaments and team uniform is included in the fee.Tier 2-10 practices - 2 Tournaments and team uniform is included in the fee. It will be the responsibility of each family to secure hotel accommodations for all tournaments. A 50% down payment is expected when you receive an invite letter or after tryouts for teams that have tryout/ID skate. Full balance must be paid at first team practice.

I, , do hereby give my approval for the player listed above to participate in the Spring 2012 Renegades Hockey Program. I fully understand that there are many inherent risks, direct and indirect in this program. Being fully aware of these risks, I am willing to permit the Player whom I am legally responsible for to participate in the program. In addition, I am willing to assume all risks inherent in and incidental to such participation, and I hereby release, absolve, indemnify and hold harmless The Renegades Hockey Club, it’s Partners, Officers, Employees, Staff and Volunteers, of any claim arising out of any injury, to me or the player. I hereby authorize and request the Renegades Hockey Club it’s Partners, Officers, Employees, Staff and Volunteers to act on my behalf according to the best judgement of the Renegades Hockey Club, it’s Partners, Officers, Employees, Staff and Volunteers under prevailing circumstances in the event of any injury, or in the event that I am not able to act for myself, or the player, or I cannot be contacted.