Registration Form

Emergency Contact Information

Disclaimer and Acknowledgement of Risk*

The applicant agrees that Brian Wilks Hockey Development (BWHD) and/or Motivation Rewards International (MRI) and/or its proprietors will not be held responsible for any accident or loss however caused, and agrees to release the proprietors from all claims or damage which may arise as a result of such accident or loss.  In event of an inability to be contacted, I hereby give BWHD or MRI permission to seek any medical attention required.

Payment Method: Cheque only

Payable To: Motivation Rewards International

Mailing Address:

28 Painted Rock Ave

Richmond Hill, Ont

L4S 1R6

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28 Painted Rock Ave

Richmond Hill, ON L4S 1R6


Tel: 416-564-6195

© 2018 by Brian Wilks Hockey Development.