Student Name
Age
 
Parent Name
Street
City
State
Zip
Student DOB 
Phone (Day)
Phone (Emergency)
Email
Position
# Years Experience
Hockey Org.
Adult Jersey Sizes S M L XL XXL (Check one)
Payment Options
Credit card # Expiration
Name on card     
 
3 Digit Card Verification Number Located on back of card
 
 


NOTE: We Do Not Accept American Express.

Promotional Code 

A check will be mailed to: Ice Works, 41 Brook Lane, Gardner, Ma 01440
Check a Session(s) :    
AAA Camp
√ Location Date Ages Time Cost Code
NESC: Marlborough, MA August 16–19 10–17 M–Th 8:00am –5:00pm $495.00
 
Early Enrollment
Price $350
*Marlborough Only		 A-MAR-01
Defensive Clinic
√ Location Date Ages Time Cost Code
NESC: Marlborough, MA July 19–22 8–12 8:00–9:30am $165.00 DEF-01
NESC: Marlborough, MA August 16–19 12–16 8:00–9:00am $145.00 DEF-02
Elite Camp
√ Location Date Ages Time Cost Code
Nantucket Ice:
Nantucket, MA		 July 5–9 8-16 7:30am–12:30pm $495.00 E-NAN-01
NESC: Marlborough, MA July 19–22 8-16 8:00am-5:00pm $395.00

Early Enrollment
Price $299
*Marlborough Only		 E-MAR-01
Nantucket Ice:
Nantucket, MA		 Aug 9–13 8-16 7:30am-12:30pm $495.00 E-NAN-02
Pre-Season Camp
√ Location Date Ages Time Cost Code
Cushing Academy: Ashburnham, MA October 18–November 22 13–17 Tues. & Thur. Nights $250.00 Individual
$225.00 Team Rate
$125.00 Goalie		 PS-ASH-01
Teamworks
√ Location Date Ages Time Cost Code
Northboro, MA. July 23 8-16 9:00AM - 3:30PM $55.00 TEAMworks-MAR01
Northboro, MA. Aug 20 8-16 9:00AM - 3:30PM $55.00 TEAMworks-MAR02


Comprehensive Hockey Assessment (CHA) - Optional

The Ice Works "Elite Hockey Training" coaching staff will provide a 10 page analysis based on a player's on and off-ice performance. The report will consist of a 2 page written evaluation along with 8 pages of graphs charting the player's performance throughout the week. Fee $40.00

    

Discount Program

FAMILY DISCOUNT:

First family member pays full price, each additional family member will receive 10% off.

GROUP DISCOUNT:

(All players must be new to the Ice Works program and a group list must be accompanied by deposits from all participating players).

5-10 players: Each will receive a 12% discount
11-16 players: Each will receive a 15% discount
17 or more players: Each will receive a 22%
      discount

MULTIPLE DISCOUNT:

Any individual attending more than one camp throughout the year will receive a 12% discount
      on all subsequent camps.

LOYALTY DISCOUNT:
 
 Any player who attended Ice Works in 2009 will receive a $20 rebate
Any player who attended Ice Works in 2008 and 2009 will receive a $35 rebate
Any player who attended Ice Works in 2007, 2008 and 2009 will receive a $50 rebate

*Limit one discount per player/per year (no discounts for goalies)

I understand that the balance of the tuition will be bill automatically to my credit card four weeks prior to the start of the camp.
Please contact the Ice Works corporate office to make other payment arrangements if needed.
 
 NOTICE:
A non-refundable deposit of $200.00 is required to reserve a spot.
Payment must be received within one week of sending the application via the Internet.

Don't forget to download your required documents!
Medical Documents required by the Commonwealth of Ma. and the State of NH.
 
Dear Applicant,

This is to inform you of some of the medical documents that The Commonwealth of Massachusetts and the State of New Hampshire are requiring all youth camps to have on file during the week of the camp. The local Board of Health will be inspecting all camps during their week of operation. If a camp does not satisfy their guidelines, the local Board of Health has the right to shut down the operation of the camp at any time. Ice Works believes in and supports the standards that the Commonwealth of Massachusetts and the State of New Hampshire has requested on our organization. Ice Works “Elite Hockey Training” encourages any law that provides protection for a child. The following documents must be mailed to Ice Works or faxed to us one week before the camp begins.
 
Certificate of Immunization – A dated report signed by a physician that specifies the month and year of administration and the type/name of the vaccine(s) administered to the camper.

Health Record
     Please fill out the enclosed health record form.

Physical
A dated physical signed by a physician within the last 12 months.
 
Forms required by Ice Works “Elite Hockey Training”
 
Application / Player Release Form
     Releases Ice Works and its sponsors of any liability.

TeamWorks Release Form
     This form is only required for players participating in the "Elite Hockey Training" in Marlboro, MA
 
Permission to Treat Form
     This form allows any member of the Ice Works staff to provide care to your child.

Many of these records are already on file with your physician, or with your local school health department. If it is easier to have your doctor’s office fax them directly to us feel free to do so. Our fax number is (978) 353-0440. Please remember that the Commonwealth of Massachusetts and the State of New Hampshire will not allow any player to participate in our camp unless these forms are on record with us.