Application form – Pittsburgh's Top Hockey Camps

Participant's Name*

First

Last

Date of birth*

Participant's email address (if any)

Participant's phone number

Parent/guardian first and last name*

First

Last

Parent/guardian email address*

Parent/guardian phone number*

Parent/guardian mailing address:*

Medical insurance Company*

Company name

Insurance Policy Number

How did you hear about us?*

Select the camp(s) you would like to attend

Choose your camps here! Attention: Early bird pricing is in effect through February 28th only!

Full Day Camp, July 22 - 26, 2024

Defense Camp, July 8 - 12, 2024

Combine Full-Day and Defense Camps

Pre-Tryout Camps DATES TBA

Choose your payment option:

On the next page, you will be able to choose your payment method: 1. Zelle - preferred 2. Check 3. PayPal (you will be charged an additional 3% fee)

InterEl Hockey Academy Waiver of liability*

I AGREE

I accept this initial waiver of liability and understand that before the camp begins I will receive printed copy of the waiver which I will be required to sign.

And enter full name of parent or guardian of the participant:*

CANCELATION AND REFUND POLICY*

I have read and accepted this policy

Due to limited camp sizes, $150 deposit per camp is not refundable. In case of confirmed medical emergency only account credit will be issued for future InterEL Academy camps.

This field should be left blank

InterEL Hockey Academy Application form

Tell us more about yourself

Select the camp(s) you would like to attend

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