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.
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