2023 Winter Skills Academy

2023 Winter Skills Academy

Location: BURNfit Athletics

1984 Northgate Commerce Pkwy, Suffolk, VA 23435

Ages: Rising kindergarten through 5th grade

5 Fun Weeks of Skill and Competition

A GREAT way to learn the game!

Saturdays ONLY

Session Dates: March 4, 11, 18, 25, April 1

Make-up days (if needed) to be determined

Sessions will be divided by grade (Grades: K- 2; 3-5)

Tentative times: 9am to 10am

All Athletes Will NEED: Shin guards, Mouthpiece and a Stick

League Cost: $85 (+$10 after February 10, 2023)

NO REFUNDS after February 22, 2023

Return check fee: $40

Any questions?? Email Tara Firth- taworl@aol.com

Participant's Name*
Age (as of 1/1/23)*
Birthdate*
Phone*
Grade (Fall 2022)*
Email*

*Parent's Email - Will be used to contact parents and athletes on schdules and other pertinent information.
Address*
City*
Zip*
State*
Level of Experience*
What are you signing up for?*
Photo Waiver
- I have read and agree to the below Photo Release Statement
I understand and will allow photos and/or videos of me and/or my child to be taken while at this activity to be used in any Girls Field Hockey, Ltd. publications/social media. I also understand that publication of these photographs may be accomplished electronically via the Internet/World Wide Web and that after publication, Girls Field Hockey, Ltd. will be unable to prevent persons from gaining access to the Internet/World Wide Web, copying my photographs and video therefrom, and subsequently using, altering, or republishing it without my consent. I waive any claim for damages against Girls Field Hockey, Ltd. from unconsented use, alteration, or republication of my photographs and video by third parties accessing the Internet/World Wide Web.
Release of Liability/ Injury Waiver*
- I have read and agree to the below Realease of Liability/ Injury Waiver Statement
As a parent of a child participating in Girls Field Hockey, Ltd. organization, I retain medical expense responsibility and do hereby release, acquit, hold harmless and forever discharge GFH, its agents, agencies, servants and employees, and all persons, natural and corporate, in privity with them or any of them from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits, and/or claims form any bodily injuries, deaths, or property damage which may be sustained by , my child(ren) while participating in any activity, including travel to and from such activities, not resulting from the intentional tortuous act or acts of any agent, servant, or employee of GFH. It is acknowledged that the decision to engage in the above activities is entered into freely, and that GFH, its agents, agencies, servants and employees have not influences the decisions to engage in such activities.
Proof of Insurance*
- I hereby certify that the above name athlete is covered by a personal insurance policy or is included in a policy that I have in force.
Medical Care*
- I hereby authorize routine medical depensary care for the above-name athlete; and I authorize treatment not considered routine to be referred to local physicians and medical facilities at my expense.
As a parent of a child participating in Girls Field Hockey, Ltd. organization, I retain medical expense responsibility and do hereby release, acquit, hold harmless and forever discharge GFH, its agents, agencies, servants and employees, and all persons, natural and corporate, in privity with them or any of them from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits, and/or claims form any bodily injuries, deaths, or property damage which may be sustained by , my child(ren) while participating in any activity, including travel to and from such activities, not resulting from the intentional tortuous act or acts of any agent, servant, or employee of GFH. It is acknowledged that the decision to engage in the above activities is entered into freely, and that GFH, its agents, agencies, servants and employees have not influences the decisions to engage in such activities.*
- I agree to the Terms of Service
Signature*
Total
$0.00