2019 Dakota Goaltending August Camp Registration 2019 Dakota Goaltending August Camp Goalies First Name * Last Name * Phone Email DOB * AGE * 5678910111213141516171819202122232425262728293031323334353637383940OVER 40 DAKOTA GOALTENDING CAMP SESSION DATES COST OF CAMP CC PAYMENT GEAR RENTAL I HAVE MY OWN GEAR I NEED TO RENT GEAR GEAR RENTAL FORM COPY AND PASTE IN A LEVEL YOU WILL PLAYING IN 2019-20 SEASON * MITES SQUIRTS PEEWEE BANTAM HIGH SCHOOL ADULT LEAGUE HOW MANY YEARS PLAYING HOCKEY * 12345678910111213141516171819202122232425 HOW MANY YEARS PLAYING GOALIE * 12345678910121314151617181920 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 * I 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 * reCAPTCHA Submit
