2013 Summer Ringette Camp Registration Form
Register quickly! We only accept 30 in our full day camps and 24 in our mini camp!
Name: ______Date of birth: MM:______DD:______YY:______
Email for camp confirmation: (PRINT CLEARLY) ______
Alberta Heath Care number: ______
Address: ______City / Province / Postal Code: ______
Parents names: ______Home phone: ______
Parent #1 cell phone: ______Parent #2 cell phone: ______
Emergency Contact during camp hours: Same as above If different, please provide information below:
Emergency Contact during camp hours: ______Phone: ______
Division and / or Tier played in 2012/13 ______
Does the registrant have allergies or medical concerns? ______
______
Athlete Fees - Please check or highlight camp(s) below:
Full Day Camp (Monday-Friday)
August 12-16, 2013 Sherwood Park Arena
Childcare included from 800am – 400pm for U9/10 & U12/14
U7 MINI Camp 9am-noon (ages 5 - 7)$200 (GST Included)
U9, U10 DAY Camp (ages 7 - 9)$350(GST Included)
U12, U14 Day Camp PLUS (ages 10-13)$425(GST Included)
High Intensity Conditioning Camp (5 evening weekend, every second day)
August 17 – August 26, 2013 Donnan Arena
9 – 11 years old (5 X 1 hour sessions) $160 (GST Included)
12 – 18 years old (5 X 1.25 hour sessions) $200 (GST Included)
Will you be trying out for an AA team in 2013/14 YES NO
TOTAL:______
Make your cheques payable to The People Coach Inc. c/o Lorrie Horne
Mail registration and cheque to: Please make sure you include:
Lorrie Horne’s Future Champions* Registration information (pg. 1)
PO Box 3062* Signed consent application & form
Sherwood Park, AB privacy of information (pg.2)
T8H 2T1* Cheque or money order only.
Cancellation Policy and Waiver: Please read and sign
All cancellations must be made in writing.
Cancellation fee prior to June 1, 2013 is $100 per camp.
No cancellations will be accepted after June 1, 2013 without a medical note.
Non-sufficient funds (NSF) Cheques - $75 Service Charge.
Please read carefully and sign:
The applicant agrees that Lorrie Horne’s Future Champions and The People Coach Inc., instructors, and /or proprietors, facilities and grounds will not be held responsible for any accident, injury or loss however caused and agrees to release the proprietors from all claims which may arise as a result, or by reason of such accidents or loss and are fully aware of the refund and cancellation policy. I agree to use the use of any pictures or video taken at the camp for use by Lorrie Horne for marketing or promotion without reimbursement. Lorrie Horne’s Future Champions Camps curriculum is the property of Lorrie Horne and no reproduction in any form is allowed. We reserve the right to request any applicant to withdraw from the school prior to its termination if we feel the participant is not acting in a responsible matter.
Registration information:
Lorrie Horne’s Future Champions and The People Coach Inc. collects your personal information in order to register you for this camp and to provide you with additional information about the upcoming programs and events (In Season Fundamental Skill Development Camps, Coaching seminars, and Summer Skill Development Camps). Lorrie Horne’s Future Champions and The People Coach Inc. will send you promotional information about other Lorrie Horne’s Future Champions and The People Coach Inc. events and programs.
If you do not wish to receive additional Lorrie Horne’s Future Champions information, please indicate below.
Please do not send me information about upcoming events with Lorrie Horne’s Future Champions.
Please do not send me promotional information about Lorrie Horne’s Future Champions.
Please do not send me information about upcoming events with The People Coach Inc.
Please do not send me promotional information about The People Coach Inc.
Photos and quotes: Lorrie Horne’s Future Champions Staff would like to take photos of participants and ask athletes for quotes regarding their experience at the upcoming summer events. The photos and quotes will be utilized both in brochures and the Future Champions website ( to promote Lorrie Horne’s Future Champions programs and events (In Season Fundamental Skill Development Camps, Coaching seminars, Summer Ringette Schools and others). If you do not wish to receive additional other Lorrie Horne’s Future Champions information, please indicate below:
Please do not use photos of my child or quote from my child on brochures or web-sites to promote upcoming events with Lorrie Horne’s Future Champions and The People Coach Inc.
Name of Participant: ______
Lorrie Horne’s Future Champions Camp attending: ______
Participant is my (daughter/ son/ etc.):______. I, ______hereby accept the terms of this
application and registration and hereby release, remise, and forever discharge Lorrie Horne’s Future Champions and The People Coach Inc. and its director or agents and all persons associated with its firm any and all liability whatsoever or responsibility whatsoever for accidents or injuries whether fatal or otherwise which may occur incidentally to or arising directly or indirectly out of Lorrie Horne’s Future Champions Camps. This is also written permission to have my child admitted and attended to for medical or dental treatment in case of sickness or injury.
This is also written permission to have my child participate in all activities including field trips. This release shall be binding on the participants, heirs, assign, executors and administrators.
Signature of Parent or Guardian or athlete over 18 years:
Signature: ______Date: ______
For more information, please contact Lorrie Horne’s Future Champions:
E-mail: or check our website: Phone: 780.722.3797