Francis Wathier

Conditioning - Dryland Camp Registration

Simply fill out this registration form
Then choose your method of payment. We offer two convenient methods:

Pay with your credit card using PayPal's secure server
Pay by mailing in a check

NOTE: You must turn OFF your pop-up blockers to pay by PayPal using this registration form, or the PayPal window will NOT open and you will not be registered.

	Full Name	Age	Gender	Skill Level	T-Shirt Size (adult size charting)
Player 1
Player 2
Player 3
Player 4

Total Cost: 199.00

Address:
Apt #:

City:
State:
Zip:

Daytime Phone:
Evening Phone:

Email:
Parents Names:

Location:
Casselman
Ferme Drouin Farm

Please select a time for BOTH Monday and Wednesday (can be different times for each day)

Mondays (July 14, 21, 28 & August 4, 11, 18)
Time:
5:30-6:45pm (7yrs-9yrs exclusively)
7:00-8:15pm (10yrs and up including adults)
8:30-9:45pm (10yrs and up including adults)
Wednesdays (July 16, 23, 30 & August 6,13,20)
Time:
5:30-6:45pm (7yrs-9yrs exclusively)
7:00-8:15pm (10yrs and up including adults)
8:30-9:45pm (10yrs and up including adults)

Cost: $199/person

AGREEMENT OF CONDITIONS:
The above information is true to the best of my knowledge. I acknowledge payment is non-refundable,and must be made to gurantee registration. Also, I understand that the dates and times are subject to FRANCIS WATHIER's training and playoff schedule and may need to change due to unforseen circumstances.
I Agree

PARENTAL CONSENT:
I have read the camp information and conditions and agree to the terms and conditions herein. I certify that the questions on the registration have been answered correctly. I herby give my consent for my child to participate in the programs operated by FRANCIS WATHIER and/or its proprietors. I further agree that FRANCIS WATHIER and/or proprietors will not be held responsible for any accidents, injury or loss, however caused, during the FRANCIS WATHIER session attended by my child or myself. This is also my written permission to have my chld admitted, and attended to, for medical or dental treatment in case of sickness or injury.
I Consent

There are two ways to pay for your Camp Registration

You can pay securely online through PayPal using your credit card
- OR -
You can pay by check

Pay with PayPal (Make sure your pop-up blockers are turned OFF before hitting 'Pay with PayPal', otherwise your payment cannot be processed.)
Pay by Check