BP Hockey College Clinic Registration
Complete the following form and waiver to register for the December 9th BP College Hockey Clinic powered by Xplosive Sports Academy.
December 9, 2018
9:00am-11:00am
$85 - mail in payment or pay on the 9th (cash, check or money order)
Send payments to: Xplosive, PO Box 732, Mt. Laurel, NJ 08054
Fulcrum Sportsplex (formerly Pinelands Sports Center), 3 Coleman Court, Southampton, NJ 08088
Questions? Email us at xplosivesportsacademy@gmail.com or call/text us at 609-254-5135
First Name *
Your answer
Last Name *
Your answer
School *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age Group *
Players age as of 12/9/18. An athlete who is 14 on 12/9 would be considered U16.
Position *
Home Address *
Your answer
City *
Your answer
State
Your answer
Zip Code *
Your answer
Email Address *
Your answer
Emergency Contact Phone Number
Your answer
Waiver
By checking agree, I hereby authorize the directors of Xplosive Sports Academy to act for me in their best judgment in all activities and any emergency medical situation including transporting and medically treating. I will not hold Xplosive/BP College liable for any injury that may result from participation. I consent to the use of photographs, videos, voice recordings, in whole or in part, of the above athlete for the purposes of advertising, publications, social media or the website.
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