Amateur Athletic
Waiver and Release of Liability
In Consideration of being allowed to participate in any way in
Kenai Peninsula Youth Foundation programs, the undersigned
acknowledges, appreciates, and agrees that:
The risk of injury from the activities involved in this program
is significant, including the potential for permanent paralysis and death, and while particular rules, equipment,
and personal discipline may reduce this risk, the risk of
serious injury does exist; and,
I knowingly and freely assume all such risks, both known
and unknown, even if arising from the negligence of the
releases or others, and assume full responsibility for my
participation; and,
I willingly agree to comply with the stated and customary
terms and conditions for participation. If however I observe any unusual significant hazard during my presence
or participation, I will remove myself from participation
and bring such to the attention of the nearest official
immediately; and,
I, for myself and on behalf of my heirs, assigns, personal
representatives and next of kin, hereby release and hold
harmless Kenai Peninsula Youth Foundation and the
City of Kenai, their offices, officials, agents and / or
employees, their participants, sponsoring agencies,
sponsors, advertisers, and, if applicable, owners and
lessees of premises used to conduct the event
(“Releases”), with respect to any and all injury, disability, death, or loss or damage to person or property,
whether arising from the negligence of the releases or
otherwise.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND
SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY
INDUCEMENT.
PROGRAM COMPONENTS

On-Ice Training — Players participating in
the Beginner Hockey Camp will receive daily intensive on-ice skill training aimed at
improving overall tactical and technical
skills. Morning ice sessions will include technical training in the areas of skating and
edge control, passing, shooting and stick
handling, while afternoon sessions will focus
primarily on offensive and defensive tactical
play, small area games and scrimmages.

Off-Ice Training — Each day, campers will
participate in a variety of off-ice training
techniques aimed at improving overall balance, agility, coordination and sport specific
techniques (shooting, stick handling, skating
-stride, etc.)

General Fitness Training — In working to
develop general levels of fitness and a strong
athletic base, participants in the KRBB
Summer Hockey Camps will be introduced
to proper lifestyle choices such as nutrition,
hydration, and sleep cycles and they will
participate in non-hockey related activities
to enhance their overall athleticism.
X __________________________ Date Signed:____________
Participant’s Name (Please Print)
FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as
provided above of all Releases, and for myself, my heirs, assigns,
and next of kin, I release participation in these programs as provided above, even if arising from their negligence.
X ______________________
Date Signed: _______________
Emergency Contact :
____________________________________
Phone:_____________________________
Kenai River Brown Bears
PO BOX 2613
Kenai, AK 99611
Phone: (907)-420-7004
Email: [email protected]
The Kenai Peninsula
Youth Foundation
Proudly Presents
OUR PROGRAM
Geoffrey Beauparlant
Director
Geoff is entering his 3rd season
with the Brown Bears, and 6th in
the NAHL. A graduate of Penn
State University and Southern New
Hampshire University, Geoff has
spent the past 11 seasons coaching and developing professional, junior, and youth hockey players.
Through his continuing effort to enhance local hockey
programs, the Brown Bears are now offering local players
an exciting opportunity to train with some of their favorite players and coaches.
CAMP STAFF
Zack Zulkanycz—Instructor
Zack has come up through the Kenai Ice
Hawks program and is a graduate of Kenai
Central High School. He has played 4 years
of junior hockey in the NAHL (Kenai River)
and USHL (Dubuque).
2015 Registration Form
CAMP OVERVIEW
The Kenai River Brown Bears Summer Hockey Camps was
developed by professional coaches with the aim of providing
a fun and supportive environment for youth players to increase their skills and knowledge of the game. All activities
have been specifically designed to allow athletes to maximize
their skill development while increasing their overall fun and
enjoyment of the sport.
Name:___________________________________ DOB:___________
Address:__________________________________________________
City/State: ____________________________________Zip:_________
Current Team:____________________ Level of Play:______________
Parents’/Guardians’:_________________________________________
Email:____________________________________________________
*All communication will be sent via email*
2015 Summer Program Fees
SAMPLE DAILY SCHEDULE
EVENT
START
END
Player Drop Off
8:00 am
8:15 am
Dynamic Warm Up
8:15 am
8:45 am
Ice Session # 1
9:00am
10:00 am
Snack
10:15 am
10:30 am
Off-Ice Training
10:45 am
11:45am
Lunch *
12:00 pm
1:00 pm
Ice Session # 2
1:30 pm
2:45pm
Off-Ice Training # 2
3:00 pm
4:00 pm
Dismissal
4:00 pm
—
All training held at the Kenai Ice Rink
All players must have current USA Hockey Registration Number
Summer Hockey Camps $250
Includes 5 full days of on and off ice training and instruction and lunch provided.
Summer Hockey Camps $200
Includes 5 full days of on and off ice training and instruction.
Week 1 - July 6-10
or
Week 2 - July 13-17
Registration Policy
Please mail registration form with signed waiver to address on back cover of the
brochure.
*Please make checks payable to Kenai River Brown Bears. A $25 service fee will
apply for any checks returned.
Registration Deadline
Deadline for the High School Hockey Camp is: 6/15/15
* Please see pricing programs
*A 50% non-refundable deposit is due at the time of registration. Payment Plans
are available upon request.
Payment Information
Tanner Schachle—Instructor
Tanner is a native of Wasilla, AK and is entering his 2nd season as a member of the
Brown Bears. He was listed as an NHL
“Player to Watch” during the 2014-15 season.
If paying by credit card, please complete the following information. A 3% convenience fee will be charged to your account.
Card Type: Visa
Master Card
Card #:______________________________
Name on Card:________________________________________________
Mailing Address:_______________________________________________
Exp. Date:______________Signature:______________________________
Colton Fletcher—Instructor
Colton is also from Wasilla, AK and entering
his 2nd season with the Brown Bears. He
was drafted by the Bears (along with
Schachle) in the 2nd round of the 2014 NAHL
Draft
Refund Policy
If in the unlikely event Kenai Peninsula Youth Foundation cancels an event, every effort will
be made to re-schedule the cancelled event. If the event cannot be rescheduled, the athlete
will be reimbursed the cost of the session.
I have read, understood, and accept the above policies for Kenai River Brown Bears:
Signature____________________________________________________Date_______________