TEAM/SIBLING TUITION DISCOUNT: (excluding grades 3 & 4)

For 15 or more attendees from the same school team there will be a $15.00 discount prior to the last day of the clinic.

Sibling discount $30.00 off each additional tuition.

NOTE:

Due to the increased enrollment demands all attendees who register after June 1, 2010 will have to pay a late registration fee of $10.

MEDICAL POLICY

Please enroll my daughter. I understand that the school and clinic will not be liable or responsible for accidents and medical or dental expenses incurred as a result of participation in this program. In the event of injury or illness the clinic has my permission to seek any emergency medical treatment deemed necessary. I authorize the use of any photography or articles about my daughter to be used by N.E. Field Hockey Clinic for publicity purposes.

I agree to the above statement

I do not agree to the above statement

Each participant must have their own medical insurance. NO ONE WILL BE PERMITTED TO ATTEND CLINIC WITHOUT THEIR INSURANCE COMPANY AND POLICY NUMBER LISTED ON THIS FORM. Please HIGHLIGHT the box, and type your information below:

 

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Make checks payable to NORTHEAST CLINICS INC.
P.O. Box 839 - East Hampstead N.H. 03826