Quick Release Hockey Academy Registration Form

Welcome to Quick Release Hockey Academy

A list of all programs along with locations can be found on the2007 Camp Dates page.

Registration Information

Confirmation letter: Confirms you in Camp and includes

complete camp schedule, balance due and camp details.

Cancellation policy: Cancellation received at least 60 days prior to camp will be refunded less a $50 administration fee. No refunds will be offered for voluntary withdrawal or for expulsion from camp.

Discounts: First family member pays full tuition, each additional member saves $25.00(for all day camps) & $10.00 (for youth & adult clinics).

Lunch Program (All Day camps only): For an additional charge of $35.00 we will provide a daily nutritionallunch design to provide each member the required food to excel and retain their energy throughout the week.

Please submit form and remit payment by phone or by mail.

Please fill out all applicable fields. (* = required)

Student name:*

Birth Date:*

(MM/DD/YY)

Parent:

or Guardian

Address:*

City:*

State:*

Postal/Zip:*

Country:*

Phone 1:*

Phone 2:

E-mail address*:

Position:

League:

Weight:

Height:

Gender:

Jersey Size:

Youth: Mens:

How did you hear about Quick Release Hockey?
(Please select one item and specify)
Specify:

Youth Program Information (See 2006 Camp Dates for information)



Lunch Program (For all Day Camps only) Yes No
Adult Program Information (See 2007 Camp Dates for information):

PAYMENT INFORMATION

Please note: Make sure to fill this electronic form out completely to insure that you are properly registered. Enrollment in all programs is limited and online registrations are not guaranteed. You will receive a return e-mail or phone call to confirm the status of your registration. To register with a check or money order as your payment option, please print this form and mail it with your check or Money Order.

Method of Payment:

Make Checks payable to Five Hole Sports.

Quick Release Hockey is Managed by Five Hole Sports.

Mail Payment to Quick Release Hockey Academy

1110 Buck Jones Rd

Raleigh, NC 27606

All Credit card transaction will be processed through Five Hole Sports..

Please call to confirm class and card number.

Notes:

Note: Your application is not confirmed until payment has been received.

Upcoming 2006 Summer Camps

Elite 5 Day Intensive Camp

Date: July 9 - 13

Time: 8am - 5pm

Location: Fredericksburg Ice Park

Cost: $395

Check back for updated camp info!