Goalie First Name*

Goalie Last Name*

Street Address*

City*

Province* Select a province Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Postal Code*

Gender* Select a gender Male Female

Date of Birth*

Provincial Health Care*

Height*

Weight*

Home Phone*

Parent 1 - Name*

Parent 1 - Email Address*

Parent 1 - Retype Email Address*

Parent 1 - Cell Phone*

Parent 2 - Name

Parent 2 - Email Address

Parent 2 - Retype Email Address

Parent 2 - Cell Phone

Community, Level, Division currently playing
(re: Springbank, PW first year, Div 4)*

Level Going in My Next Tryout (for summer camp registration only)

DMSG Jersey*

DMSG Jersey Size*

Food Allergy*

Please Specify Food Allergy Details*

Notes and Other Comments

Coupon Code

Registration Agreement & Waiver Responsibility

As a registrant or shooter in the DMSG (group or Private sessions), the registrant and his/her parents and/or guardian agree that the DMSG and/or its staff and/or organizers and/or directors will not be held responsible or liable for any injury to the registrant arising out of or in connection with the operation or activities of DMSG, including but not limited to bodily harm are assumed by the student and/or his parents and/or legal guardian and that this assumption is acknowledged.

Registration Agreement*

FOIP Agreement*

Payment Information*

Cheques should be made to David Marcoux's School of Goaltending. Mail to D.M.S.G. 11 Aspen Cliff Place S.W, Calgary, AB, T3H 0M1

Cancellation and refund policy

If a registrant must cancel due to sickness or injury prior to the Camp, DMSG will issue a credit for an upcoming clinic, Camp or Private lesson. Under no circumstances will this be converted to cash refund. A $50 administrative fee is applicable. The registrant athlete has one year to benefit from this credit (from date of registration).

At camp injuries

DMSG does not provide refunds or credits for lost participation due to injury at camp. Since we turn potential registrants away to preserve the camp structure and ratios, we have no method of recovering lost revenue due to cancellations.

* This is a tentative schedule, and we need a minimum of registrants in order for the camp to take place.