Gillette, WY Clinic Registration

WHERE GOALIES BECOME GOALROBBERS!

2022 Gillette, WY Goalie Clinic: September 16th-18th

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Gillette, WY Goalie Camp Registration

Camp Cost: $295 Includes jersey & learning resources You must complete this registration in full and the following payment page to secure your spot. Registration spots will be reserved on a first come first serve basis. Once camp is full, we will create a waiting list on the same basis.
Parent / Guardian Info
Parent / Guardian Name*
First Last
Parent / Guardian Email*
Enter Email Confirm Email

Phone*
Participant Info
Participant Name*
First Last
Participant Email
Enter Email Confirm Email

Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Age*
Gender

Male

Female
Birth Date*
MM slash DD slash YYYY

Hockey Level for Upcoming Season*
First time Goalrobber Camp Participant*
Will this be your first time attending a Goalrobber Hockey School?

Yes

No
How did you find out about camp?

Medical and General Infomation Form
The following information is required. All participants must have health insurance and all requested information in order to participate in Goalrobber Hockey Schools and/or any Goalrobber affiliated programs.
Medical Insurance Company*

Medical Insurance Number*

Please list any additional health or treatment info we should have on file.
Goalrobber Terms of Service
I.) I hereby acknowledge and agree to my child’s participation in and attendance at Goalrobber Hockey Schools and affiliated activities. II.) I do hereby release and hold harmless the Goalrobber Hockey Schools LLC, its officers, directors, employees, independent contractors or agents all resources, claims, causes of action of any kind whatsoever in respect of all personal injuries, including death or property losses which may be suffered as arising out of or connected with the preparation in and attendance at Goalrobber programs and activities; notwithstanding that such injuries or losses may have been caused solely or partly by the negligence of the Goalrobber Hockey Schools or any of its offices, directors, employees, independent contractors or agents. III.) I grant permission to Goalrobber Hockey Schools to use my image(s) (photographs and/or videos) for use in media publications including, but not limited to, the following: social media, newsletters, general publications, website and/or affiliates, and emails. I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of the image. IV.) REFUND POLICY: I hereby acknowledge and understand that all purchases made are final. If I or my child is unable to attend camp and has already completed all payments in full, I hereby understand that 50% of the camp fee is non-refundable. The remaining 50% of camp will only be refunded in the form of credit to future Goalrobber activities, goods, or services sold.
I have read the complete application and agree to the terms as described therein. I certify that all the questions on the application have been answered correctly. I understand that no refunds will be made for any reason other than the refunds policy provided. This is also my consent, for my child to receive emergency medical assistance by a trained professional in case of accident.*

I Agree
Dated*
MM slash DD slash YYYY

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WHERE GOALIES BECOME GOALROBBERS!

2022 Gillette, WY Goalie Clinic: September 16th-18th

Gillette, WY Goalie Camp Registration

Parent / Guardian Info

Participant Info

Medical and General Infomation Form

Goalrobber Terms of Service

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