Billy Pye Summer Annual Goalie CampText Box: Valley Ranch Star Center 211 Cowboy Parkway Irving, TX 75063 June 15-19th Monday-Friday 9:45am-2:15pm Register at billypyethegoalieguy.com Text Box: Billy Pye Hockey, Inc. 4601 Gila Bend Lane Fort Worth, TX 76137 Text Box: Registration Name:____________________ Email:____________________ Age:____________ Years of Exp.____ Circle: Advanced / Beginner Phone:____________________ Liability Waiver This waiver must be signed by a Parent or Legal Guardian before any activity is allowed. NO EXCEPTION. I,______________ (print) the Parent/Legal Guardian of______________________ Release Billy Pye, Billy Pye Hockey, Inc., or any instructor with the camp of any liability to injury that may occur. I am aware of the risks and will be responsible medically and financially for any accidents that might occur. Signature:______________________ Date:_________________________ Emergency Phone Numbers: __________________________________________________________