First Name (*)

Last Name (*)



Postal Code

Your Email (*)

Primary Phone(*)

Business Phone



Birth Year (*)


Current Team

Enter the name of the program you are signing up for and the start date as well.

The applicant agrees that GOLDEN GLIDE HOCKEY, its proprietors, participants and employees, will not be responsible for any accident or loss however caused, and agrees to release them from all claims and damages which may arise as a result of such accidents or loss. In the event that the applicant is incapacitated, or if the applicant is a child, I herby give you permission to seek out any necessary medical assistance required. In signing the application, the applicant acknowledges that he/she has read and understands the conditions and certifies that he/she is in good physical and mental health .

Waiver Agreement (*)
I Agree