Alexander Goaltending, Moncton, New Brunswick, Application Download or Apply online

Please choose your Program and fill out application below to register. This application is also offered in PDF format for those who prefer to pay by cheque.

Download Application

Name:

Email:

Address

City:

Province/State:

Postal/Zip Code:

Birth date/year:

Age Division:

Team Classification (ie. recreational, AA etc.)

Telephone (home):

Telephone (work):

Telephone (emergency):

Medical/Hospital Number:

Program Requested:

Program Cost:

Jersey Size - Mens:

(Jerseys not provided with all programs)

WAIVER:

I understand and I / my child / my ward agree(s) that Alexander Goaltending, it's instructors, the ice hockey arenas and it's employees will not be liable or held responsible for any accident or loss however caused and agree to release all mentioned parties from all claims and damages. I further verify that my child / my ward has no medical conditions that would preclude his/her participation in any training sessions and that the above mentioned parties will not be held responsible for any medical, dental, or insurance claims resulting from injury. I further understand and I / my child / my ward agree(s) that while in attendance at any Alexander Goaltending camps photos and / or videos may be taken which may be used for promotional purposes. These photos / videos become the exclusive property of Alexander Goaltending.

I Agree

Please indicate if you prefer either of these methods to make your payment:

E-transfer

Cash

Cheque

Debit or Credit card

PLEASE NOTE:

If using any of the above methods; E-transfer, cash or cheque; you must make arrangements for payment (deposit, partial or full payment) IMMEDIATELY within 24 hours of submitting your application.

For Credit or debit card payment, please Click on the Paypal Button after submitting this form. You will have 48 hours to submit your payment through Paypal.

This application WILL NOT be considered as being received until the required deposit, partial or full payment is made and so your camp slot is not reserved.

Date:

Verification