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PLEASE FILL IN THE FORM BELOW.

I HAVE READ THIS WAIVER, RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND AND AGREE TO THIS AGREEMENT.

Waiver:
Agree
Disagree
  *
Camp Location / Date::
  *
Participant's Name:
  *
Payer's Name (for credit card if paying by check please type 'check')::
Player's Date of Birth mm/dd/yy::
Email Address::
Phone Number in case of emergency::
Club Team:
Please Select Your Ability Level::
Division 2
Division Super 2
Division 1
Premier
* Required field
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