50/50 program

We hope everyone had fun last night! I know we did :)

I promised to email out the form for the 50/50 program. I can't upload a form on here (or if I can't I don't know how to!), but here is the info copied/pasted butI am sure Owens has some on site. Justin will be participating and I hope others can too!

Spring 50/50
April 11th-May 23rd 2010
NO PRACTICE 5/9/10
Mini-Mites-Squirts
If you’ve got a hockey lover, this will keep’em going. Thirty minutes of instruction followed by 30 minutes of scrimmage during this class that meets once a week for 6 weeks. Goaltenders are welcome (limited to 4 goalies).
Two separate times based on age division:
Mini Mites/Mites Mite Travel & Squirts
Sundays @ 10:00 am Sundays @ 11:15 am
Player instruction will be by Zac Tortorella.
The purpose of the program is to offer a mix of instruction that will be applied to scrimmages. Players will be divided into two teams and should bring both a light and dark color jersey to all sessions. Each scrimmage will be supervised and officiated by a Park District Employee, who will assign positions and make line changes in this “No Coach Format”. All USA Hockey rules will apply.
Cost: Player fee $65
Goaltender fee $35
If paid after 3/21/10 $70 player or $40 Goaltender
Registration Due 4/4/10
If you have any question please contact Zac Tortorella @ 686-3368 or ztortorella@peoriaparks.org
50/50 Registration Form
(Please read & sign the waiver on the reverse side of this form.)
Name:_______________________________________Address:_____________________________________________
City:________________________State:______ Zip:___________Day Phone:____________________________________
Evening Phone:__________________________________Email:______________________________________________
2009-2010 Team:______________________________ Position:________________
DOB:_____/_____/______
Circle Division & Time
Mini Mites/Mites Mite Travel & Squirts
Sundays @ 10:00am Sundays @ 11:15am
Mail Registration & Check To: Owens Center
(Make Check payable to Zac Tortorella) 1019 W. Lake
Peoria, IL 61614
Date paid______ Taken By ______ Amount ______ Cash______ Check ______ Check #______
Waiver (must be signed for participation)
Please read this form carefully and be aware in registering yourself, your child or ward from participation in this program you will be waiving and releasing all claims from injuries you or your minor child/ward might sustain arising out of this program. As a participant in the program or the parent/guardian of a participant in the program, I recognize and acknowledge that there are certain risks of physical injuries, including death, damages or loss which I or my minor child/ward may sustain as a result of participating in any and all activities connected with or associated with such program. I agree to waive and relinquish all claims I or my minor child/ward may have as a result of participating in the program against the Park District and its officers, agents, servants and employees. I do hereby fully release and discharge the Park District and its officers, agents, servants and employees from any and all claims from injuries, including death, damage or loss which I or my minor/ward may have or which may accrue to me or my minor/ward on account of my participation in the program. I further agree to indemnify and hold harmless and defend the Park District and its officers, agents, servants and employees from any and all claims resulting from injuries, including death, damages and losses sustained by me or my minor/ward and arising out of, connected with, or in any way associated with the activities of the program. In case of accident or sickness, I consent to emergency medical care provided by ambulance or hospital personnel. I hereby consent to the use of my photograph in Park District brochures, publications, slide presentation, etc. I have read and fully understand the above Program Details and Waiver and Release of All Claims.
______________________________________________________________ Date:_______________________
Signature of Parent/Guardian
(If participant is under 18 years old)