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2011 - 2012 Tryout Registration

2011-2012 Omaha AAA Hockey Tryout Registration

U18 Team - July 23rd and 24th - (deadline for registering is Friday July 22nd, 2011)

Thank you for registering for the 2011-2012 Omaha AAA tryout(s).  Please note, all of the below fields are required to submit your registration.  Incomplete forms will not be processed.

USA Hockey Registration:

Omaha AAA hockey requires all participants to be registered with USA Hockey (USAH) prior to signing up for the 2011-2012 tryout. If you are not currently registered with USAH, you must register with USA Hockey before proceeding.

Payment

To pay by check or cash, please mail $175 to:
Omaha AAA Hockey Club
16337 Page Street
Omaha, NE 68118

To pay by credit or debit card, please select the Pay Now button below (* note: a 3% service charge is added for PayPal transactions).  After submitting payment, you will be redirected back to this page to complete the registration information below and submit. 

* Payment must be received no later than 5 days prior to camp.

Registration


USAH Registration Number
Last Name:
First Name:

Birthdate:
Year

Month

Day
Address:
Parent / Guardian Last Name:

Parent / Guardian First Name:
Phone Number 1:
Phone Number 2:

Email Address:
Tryout Selection:

U18
U16
Weight:

Height:
Grade Next Year:
Cumulative GPA:
Position:

 Forward
Defenseman
Goalie

Shot / Glove:
Left
Right
Last Season Team / Level:

Last Season's Coach:
Last Season's Coach Phone:

Consent To Treat:

 I Certify that as a parent or guardian of said participant, I give consent to obtain medical care from any licensed physician, hospital, or clinic for said participant, for any injury that could arise from participation in any activities associated with the sanctioned Omaha AAA Hockey Club.
Electronic Signature: I have read, understand and agree to Comply with the Consent to Treat as outlined above.

Release of Liability:

In Consideration of being permitted to participate in hockey and skating activities, I understand and appreciate that the risk of serious personal injury is significant, including the potential for permanent paralysis and death and voluntarily assume and accept those risks.  

I unconditionally release, waive and covenant not to sue Omaha AAA Hockey Club, their boards of directors or officers/consultants, any of their affiliates, their promotional sponsors and advertisers and all their agents, volunteers and employees from any and all suits, claims and demands of any kind for personal injuries, property damage including but not limited to, lost or stolen goods. By my child participating, "I Knowingly Assume Risks", both known and unknown.

Further, I have read, understand and agree to the waiver of liability, release, and indemnity agreement as printed on the back of the USA Hockey individual membership registration form and confirm that the absence of my signature on that form is due only to administrative facilitation of my child's electronic registration.  
Electronic Signature: I have read, understand and agree to comply with the Release of Liability as outlined above.


The cost per player for the camp is $175.

Please remember that all fields are required before submitting.

What kind of off-season training do you primarily participate in?