KAMLOOPS SUMMER ELITE CAMP

Head Instructors: Ed Patterson, former Kamloops Blazer and Pittsburgh Penguin

Igor Chibirev, former Hartford Whaler and Soviet Red Army

Camp Program Director: George Cochrane, KMHA Head Coach

Off-Ice Program Coordinator: Greg Kozoris of Acceleration Strength and Conditioning

August 12th to 16th

at Brock Arena

5 Day Elite Camp for Ages 9-14 (Atom to Bantam)

Camp is designed for Atom Development and Rep players

to prepare them for tryouts and the upcoming season.

Players will receive 2.5 hours on-ice and 2 hours off-ice

On-ice Program to include: Off-Ice Program to include:

- Individual Skill Development - Core Strength Training

- High-tempo Skills and Drills - Foot speed, Agility, Balance

- Battle and Compete Drills - Plyometrics and Explosiveness

- Offensive and Defensive Skills and Tactics - Stickhandling

- Conditioning

REGISTRATION DEADLINE JUNE 15, 2012

Cost: $495.00

Registration Priority will be given to players that have played Atom Development and Rep

Registration includes a Jersey and Lunch each day

For More Information Visit KMHA Website:

www.kamloopsminorhockey.com

or Contact George Cochrane

Email:

Phone: 250-376-2601 (office)

250-574-3846 (cell)

SUMMER ELITE CAMP (Aug. 12-16)

REGISTRATION

FULLY COMPLETE REGISTRATION FORM

NAME: ______MAILING ADDRESS:______

CITY: ______POSTAL CODE: ______

PARENT(S): _____EMAIL: ____

PHONE: (H) ______(CELL)______DOB: ____AGE AT DEC. 31/13:______

LAST YEAR’S TEAM: ______

50% due at registration, 2nd payment due June 15th, 2013 (by post-dated cheque) NO REFUNDS GIVEN – CREDIT FOR NEXT YEARS CAMP

Please make cheques payable to: KAMLOOPS MINOR HOCKEY ASSOCIATION, PO BOX 24018, #70 - 700 TRANQUILLE RD, KAMLOOPS, BC, V2B 8R3 Confirmation will be e-mailed.

AMATEUR ATHLETIC

WAIVER AND RELEASE OF LIABILITY

**PLEASE COMPLETE**

In consideration of being allowed to participate in any way in the Kamloops Minor Hockey Association Summer Camp, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Kamloops Minor Hockey Association, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and leasers of premises used to conduct the event

(“Releases”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

FOR PARTICIPANTS OF MINORITY AGE

(UNDER AGE 18 AT TIME OF REGISTRATION)

This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releases from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above.

X______

PARENT/GUARDIAN’S SIGNATURE EMERGENCY PHONE #

X______DATE: ______

WITNESS