REGISTRATION FORM
WEST GENESEE WILDCATS
Player: ___________________________________
Division:
Position:
Mite (09-07)
Goaltender
Squirt (06-05)
Defense
Peewee (04-03)
Forward
August 3-15
Bantam (02-01 *Boys Only)
Varsity (00-97 *Boys Only)
DOB: ______________
Home Address:
_________________________________________
_________________________________________
Email Address:
_________________________________________
Parent/Guardian:
_________________________________________
Phone #:
_________________________________________
WAIVER FOR PARTICIPATION
Waiver must be read and signed for before
registration is accepted.
I assume all risks and hazards incidental to the conduct of the
program(s), which I have listed, and to hereby further release
and hold harmless the Town of Camillus & Town of Camillus
Parks and Recreation staff. I give permission to a licensed
physician or hospital staff to administer emergency medical
care deemed necessary or myself/my child when normal
permission is unavailable. I certify that I/my child am in good
physical health and have no limitations other than those I
have listed, which may predispose me to risk during this
program. I also fully realize that I must provide proper
hospitalization. The Town of Camillus does not provide health
insurance coverage.
Signature of Parent/Guardian:
SUMMER HOCKEY CAMP 2015
Date:
____________________________________
Shove Park
The West Genesee Wildcats Ice Hockey Staff, in
conjunction with the Town of Camillus Parks &
Recreation Department offer a unique summer
hockey development experience. The West
Genesee Wildcats Summer Hockey Camp
provides players a combination of instructional
practices, full-ice games, and a 3v3
Tournament. A Wildcats hockey practice jersey
is provided to all players.
INSTRUCTIONAL STAFF
Frank Colabufo, West Genesee Wildcats, Head Coach
Scott McDonald, West Genesee Wildcats, Assistant Coach
Dan Alfieri, West Genesee Wildcats, Assistant Coach
Sean Coakley, West Genesee Wildcats, Assistant Coach
Bobby Shattell, West Genesee Wildcats, Assistant Coach
Eric Burns, West Genesee Wildcats, Assistant Coach
Stephen Mallaro, SUNY Brockport, Assistant Coach
HOCKEY CAMP SCHEDULE
Monday-Friday, August 3-14, 2015
Mites: 8:30 AM - 9:45 AM, Game at 5:45 PM
Squirts: 10:00 AM - 11:30 AM, Game at 6:45 PM
Peewees: 11:45 AM - 1:15 PM, Game at 7:45 PM
Bantams: 1:30 PM - 3:00 PM, Game at 8:45 PM
Varsity: 3:15 PM - 5:30 PM
3v3 Tournament
Mites: Saturday, August, 8, 8:00 AM-12:00 PM
Squirts: Saturday, August 8, 12:30 PM-4:30 PM
Varsity: Sunday, August 9, 10:00 AM-2:00 PM
Peewees: Saturday, August 15, 8:00 AM-12:00 PM
Bantams: Saturday, August 15, 12:30 PM-4:30 PM
REGISTRATION DATES
PREFERRED REGISTRATION
MARCH 16 - MAY 1
Town of Camillus Residents
West Genesee School District Residents
Camillus Youth Hockey Members
OPEN REGISTRATION
MAY 4
Until Division is closed
REGISTRATION FEE: $225
Family Discount: $195 each additional child
Checks Payable to:
Camillus Parks & Recreation Department
Mail Check & Registration to:
Camillus Parks & Recreation Department
4600 West Genesee Street
Syracuse, New York 13219
CANCELLATIONS & REFUNDS
After May 4, 2015 refund requests must come
directly to the Parks & Recreation office prior to
program start date and will be charged a $100
cancellation fee unless:
1. The Parks & Recreation Department cancels
the division.
2. A waiting list exists for the division and
someone off the waiting list can fill the spot
that has vacated.
3. The request is accompanied by a doctor’s
written excuse (this will be pro-rated at the
discretion of the department).
4. No refunds will be given once a program
begins.