Date of Birth
Camp location that I am registering for
, Alberta (Sunday, April 29th)
Langley, British Columbia (Monday, April 30th & Tuesday, May 1st)
Moose Jaw, Saskatchewan (Wednesday, May 2nd)
Mont-Royal, Quebec (Thursday, May 3rd)
Oakville, Ontario (Friday, May 4th & Saturday, May 5th)
Unable to attend a Tryout Camp
Please tell us why you are unable to attend the tryout.
Teams I wish to be considered for. You may select more than 1.
Veteran's World Cup in Czech Republic (Men 45+) 1973 birth year & older
Master's World Cup in Czech Republic (Men 37+) 1980 birth year & older
FIRS World Championships in Italy (Sr Men) 1998 birth year & older
FIRS World Championships in Italy (Jr Men) 1999, 2000, 2001, 2002 birth years
FIRS World Championships in Italy (Sr Women) 2002 birth year & older
FIRS World Championships in Italy (Jr Women) 1999, 2000, 2001, 2002, 2003, 2004 birth years
AAU California (08U) 2009 & 2010 birth years
AAU California (10U) 2007 & 2008 birth years
AAU California (12U) 2005 & 2006 birth years
AAU California (14U) 2003 & 2004 birth years
AAU California (16U) 2001 & 2002 birth years
AAU California (18U) 1999 & 2000 birth years
AAU California (23U) 1994, 1995, 1996, 1997 & 1998 birth years
AAU California (Sr Men) 1998 birth year & older
AAU California (Masters Men 35+) 1983 birth year & older
AAU California (Jr & Sr Women) 2004 birth year & older
Email Address of Player
Phone Number of Player
Newfoundland & Labrador
Prince Edward Island
Name of a Parent / Guardian (If minor)
Phone Number of a Parent / Guardian (If minor)
Email Address of a Parent / Guardian (If minor)
Tell Us About Your Hockey Background (Ice and Inline Hockey)
Please provide any online links and references to support your hockey background. Please also include any names and phone numbers of coaches / other who can support your hockey resume.
Tryout Release & Waiver
I hereby acknowledge and agree that in consideration of being able to participate in the Canada Inline tryouts, games, exhibitions, tournaments, performances, programs or activities organized. Operated or sanctioned by the Canada Inline and in consideration of the time, effort and money expended by the Canada Inline in organizing, operating, or sanctioning such programs or activities and for other good and valuable consideration the receipt of which is hereby acknowledged:
1. I do hereby RELEASE the Canada Inline; its' officers, directors, employees, contractors, servants, agents, and members from all claims, damages, causes of action or any recourse whatsoever. In respect of all personal injuries or damage to property which may occur while attending or participating in Canada Inline tryouts, games, exhibitions, tournaments, performances, programs and activities and do DISCHARGE those parties from any and all such liability.
2. I do hereby acknowledge and agree that the sport of roller hockey and its programs and activities are by their nature RISKY and HAZARDOUS and I ACCEPT ALL PERSONAL RESPONSIBILITY for those risks and hazards notwithstanding that any personal injury or loss of property which may incur is due to the negligence of the Canada Inline or any of its officers, directors, employees, contractors, servants, agents, and members.
3. I do hereby acknowledge and agree that notwithstanding the generality of the foregoing I declare that I will not commence litigation or otherwise recover damages or other compensation for personal injury or loss of property against any of the parties named herein based on any claim, damages, causes of action or any recourse whatsoever arising out of games, exhibitions, tournaments, performances, programs, and activities organized, operated or sanctioned by the Canada Inline as a COMPLETE DEFENSE to any and all claims, damages, causes of action, or recourse or liability which may arise at any time.
4. GRANT to CANADA INLINE, without further compensation, the unrestricted right to publish, in its discretion, my name, photograph, portrait, likeness, voice and any film rendering or tape recording of me for advertising and promotional purposes in connection with the CANADA INLINE / INLINE HOCKEY in any form of publication or display including, without limitation, newspapers and other print publications, radio and television broadcasts, film releases and interactive media worldwide;
I have carefully read this release and waiver, which I fully understand, and I am freely and voluntarily acknowledging and accepting it. I expressly acknowledge that I have the option of not participating in the games, exhibitions, tournaments, programs, or activities organized or sanctioned by the Canada Inline but do so upon the terms and conditions set out above.
I have read, accept and agree to the above Tryout Waiver & Release.
By entering my name above, not only am I confirming that I have read, accept and agree to the Tryout Waiver & Release, but I am also confirming that I am either 18 years of age and older or I am a parent and am accepting and agreeing on behalf of my son or daughter.
Please complete this Player Gear Section in the event you are selected for one of the teams.
By filling out this information,
We are curious.....How did you hear/learn about tryouts?
You were at tryouts last year and received an email about it.
You saw a poster at your local rink.
You saw a post on social media.
You received an email from a league you play in.
A friend of yours informed you about it.
If you answered other above, please explain.
Early Bird Tryout Fee ($65) until April 25th, 2017. After April 25th, registration will be $85 (This includes walk ups on the day of)
$ 65.00 CAD
$ 0.00 CAD
Email address linked up or associated with PayPal
What is the email address linked up or associated with the PayPal account you are using to pay with? (This is for accounting purposes so we can cross reference players payments)
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