MACY HOCKEY
1717 E Witzke Blvd 1640Fernando Dr.
(920) 830-7679 (920) 403-2000
Summer Hockey for all levels!
This league is designed for participants eager to play hockey in the off season.
Limited travel is required, as games will be held at two locations weekly.
Games will be held between June 17, 2008 and August 19, 2008.
All games in all locations will be played on Tuesday or Wednesday nights!
Mites 6:00PM
Squirts 7:00PM
Peewees 8:00PM
Bantams 9:00PM
Schedule of your team and games will be sent out when teams are full!
Please register at your home rink in order to be placed on the correct team!
Fee: $115.00 per player
$60.00 per goalie
Players Name__________________________________Age______
Position________________
Address__________________________________
City________________Zip_______________
Phone________________Cell_____________
E-mail___________________________________
Age Level: Mite Squirt Peewee Bantam
Parent/Guardian Name (printed)__________________________________________________
Interested in bench assisting: yes no
Emergency contact:____________________________Emergency Phone__________________
I hereby certify that my child is in good health and capable of safe participation in this program. I am aware that in signing
And participating in the program. I waive and release all claims for injuries sustained arising out or this program, including
Transportation services, when provided. I recognize and acknowledge there are certain risks of physical injury and agree to
Assume the full risk of injuries, damages or losses which may be sustained as a result of participating in any and all activities
Associated with such programs. I hereby release and discharge the Appleton Family Ice Center, Inc. and Cornerstone Community Center, Inc. , their officers, agents, volunteers and staff from all claims resulting in injuries or damage and losses due to participation in the activities provided by these organizations. Furthermore, I agree that my child and myself will follow all policies and guidelines of the named organizations while participating in any activities at the Appleton Family Ice Center or Cornerstone Community Center and understand failure to do so may result in removal of myself or my child from such programs without a refund. I indemnify, hold harmless and defend the named organizations, officers, volunteers and staff from all connection with or in any way associated with the activities provided. I have read and fully understand this waiver and release of all claims.
Signature of Parent or Guardian:____________________________________________
Date:____________________ *$25 Service Fee on all returned checks – NO REFUNDS*
Make Checks payable and mail to:
DePere, WI 54115