This document is a registration form for DuPraw Powerskating camps and clinics. It requests information such as name, age, position, address, emergency contact, and home rink. Participants can register for programs in March, April, June or July and are grouped by age as either 5-10 years old or 11 and older. Signing the liability waiver releases the instructors and rink from any injury claims. A deposit is required to reserve a spot, with balance due before taking the ice. The form provides contact information for Ryan DuPraw and notes discounts available for team rates or combining a spring break clinic with summer school.

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DuPraw Powerskating
REGISTRATION FORM
Name: _____________________________________ Age:_______ Position(Circle): C LW RW D G
Address: _________________________________________________________________________________
Phone (H): __________________________________ Emergency: _________________________________
Parent/Guardian: _________________________________________________________________________
Home Rink: _________________________________ Email: _____________________________________
CIRCLE PROGRAM
MARCH SPRING BREAK APRIL SPRING BREAK
JUNE ADULT CAMP JULY SUMMER SCHOOL CHECKING CLINIC
CIRCLE GROUP
A: ( 5-10 YR. OLD ) B: (11 AND UP )
LIABILITY WAIVER
I agree to release DuPraw Powerskating and it’s instructors, including this event rink and its employees, from all claims, damages and
actions of the undersigned person or parent guardian. I assume full responsibility for any bodily injury that may occur as a result of
the inherent risks of skating. I further agree that DuPraw Powerskating has the right to excuse this participant without refund for any
behavioral or damaging acts to the players, instructors, and equipment in this camp.
Sign & Date
Parent / Guardian / Participant _______________________________________________________________________________
A players spot in a camp/clinic can be guaranteed by submitting a non-refundable deposit.
Refunds will be given at 100% less the non-refundable deposit.
All Clinics require a 25.00 deposit
Summer School requires a 50.00 deposit
Balance is due prior to skater stepping on ice.
PLEASE MAKE CHECKS AND MONEY ORDERS PAYABLE TO: DUPRAW POWERSKATING
RETURN PAYMENT AND REGISTRATION TO: TECO ARENA RECREATION OFFICE
OR MAIL TO:
ATTN: RYAN DUPRAW
11000 EVERBLADES PARKWAY
ESTERO, FLORIDA 33928
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Ask Ryan about his team discounts &
Southwest Florida Hockey Academy Discounts
BONUS!!!
Take one of Ryan’s spring break clinics
and receive $25.00 off a summer school
(limit one per camp/clinic)
Ask Ryan about:
PRIVATE ONE-ON-ONE TRAINING
GROUP OR TEAM SKATING/HOCKEY CLINICS
OFF-ICE OVERSPEED/POWER/TECHNIQUE TRAINING
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