2019 Dakota Goaltending Fall Camp Registration 2019 Dakota Goaltending Fall Camp Registration First Name * Last Name * Address * City * State * AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Zip * Phone * Email * DOB * Age * 56789101112131415161718192021222324252627282930 Dakota Goaltending Fall Camp Session * $240 by Sept. 15th 2019 $300 after Sept. 16th 2019 Dakota Goaltending Dates & Times Thursday 9/19/19 6:45-7:45pm Thursday 9/26/19 6:45-7:45pm Thursday 10/3/19 7:45-8:45pm Thursday 10/10/19 6:15-7:15pm Thursday 10/17/19 6:15-7:15pm CC Payment: Copy and past the link http://www.rhinohockeysiouxfalls.com/dakota-goaltending-payment/ LEVEL YOU WILL PLAYING IN 2019-20 SEASON * Mites Squirts PeeWee Bantam High School Adult How many years played hockey * 1234567891011121314151617181920+ How many years played goalie * 1234567891011121314151617181920+ Photo Release * By checking this box, I grant to Rhino Hockey, LLC and Dakota Goaltending the right to take photographs of my child in connection with the above-identified organization. I authorize RHLLC/Dakota Goaltending, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that RHLLC & Dakota Goaltending may use such photographs of my child with or without my childs name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. By checking this box, I DO NOT grant to Rhino Hockey, LLC or Dakota Goaltending the right to take photographs of me in connection with the above-identified organization. Waiver * assume all risks and hazards incidental to such participation and do hereby waive, release, absolve, indemnify, and agree to hold harmless Rhino Hockey L.L.C. & Dakota Goaltending the organization, sponsors, supervisors, participants, coaches, captains, officials, and its associates for any claim arising out of an injury of accident Insurance * Parent or Guardian Signature * Date * Paragraph reCAPTCHA Submit
