PLAYER Winter 2008-2009 INFORMATION      

   Please fill out completely and return this information sheet along with the following:

 Full or 1st payment towards dues by FIRST GAME (Checks Payable to “VALLEY ICE CENTER”). All Players MUST be registered with USA Hockey. Please REGISTER FOR USA HOCKEY ONLINE ONLY! USA Insurance must be renewed this Winter Season.

                                                                                PLEASE PRINT CLEARLY    

NAME: _______________________________________________________________BIRTH DATE____________________________________

ADDRESS:__________________________________________CITY________________________________ST________ZIP________________

HOME PHONE :__________________________________________   WORK PHONE:______________________________________________

CELL PHONE: _____________________________________ E-MAIL: _______________________________________________

LEVEL________________________________TEAM NAME_________________________________________________________________

                                 Winter 2008-2009

                                                                                    ÿ        PLAN I - PAYMENT IN FULL - $550.00

ÿ   AMEX                     ÿ   VISA                     ÿ  M /C                                     

                    

     CC #________________________________________       ÿ          PLAN II- INSTALLMENT PLAN_ -  $580.00

                                                                                                                      To be paid in 2 payments as follows:

     Exp. Date________________________                                           Down payment:  By  Registration        $ 350.00

                                                                                                                     2nd Payment:  By December 9, 2008 +  $ 230.00        

                                                                                                                                                                                Total=    $ 580.00

     Amount $ ________________________                                                                                 

                                                                                                           

     Signature ____________________________________    

                 ÿ     GOALIE SPECIAL DISCOUNT PRICE -    $275.00

 

                                                                                                

DUES COVER:                                                                  NOTE: As a courtesy to our players, there will be 2   

              l      20 Regular Season games                                          payments to our Installment plan. However, if                

l        Playoff games, if team is eligible                             you miss one payment, your name will be taken out of the      

              l     Awards to championship team members                   roster!

                                                                                                                 

                                                                               There will be no refunds!!!                    

 

INJURIES: All injuries must be reported to the scorekeeper or League office within 24 hours.  There is a 2 game injury/grace period.   The injured player will remain on the team roster for two subsequent games.  After this "grace" period, it is the responsibility of the player/rep to notify the office in writing if he/she will continue playing or be leaving team due to the injury.

PLEASE READ CAREFULLY

WAIVER AND RELEASE OF LIABILITY VALLEY ICE CENTER ./PANORAMA CITY.

                   In consideration of being allowed to participate in any way in sports programs and other sponsored activities at or by LEAGUE, the undersigned acknowledges and agrees as follows:

 

I ACKNOWLEDGE AND FULLY UNDERSTAND THAT I WILL BE ENGAGING IN ACTIVITIES THAT INVOLVE RISK OF SERIOUS INJURY, INCLUDING PERMANENT DISABILITY AND DEATH, AND SEVERE SOCIAL AND ECONOMIC LOSSES WHICH MIGHT RESULT NOT ONLY FROM MY OWN ACTIONS, INACTIONS, OR NEGLIGENCE, BUT ALSO FROM THE ACTION, INACTION OR NEGLIGENCE OF OTHERS, THE RULES OF PLAY, OR THE CONDITION OF THE PREMISES OR COMPETITION AREA OR ANY EQUIPMENT USED, FURTHER, THAT THERE MAY BE OTHER RISKS NOT KNOWN TO ME OR NOT REASONABLY FORESEEABLE AT THIS TIME.

                             I AGREE THAT PRIOR TO PARTICIPATING IN ANY ACTIVITY SPONSORED BY LEAGUE,  I WILL INSPECT THE COMPETITION AREA AND ALL EQUIPMENT TO BE USED, AND IF,         

                            THROUGH MY INSPECTION, I DETERMINE THAT ANYTHING RELATED TO THAT ACTIVITY I S UNSAFE, I WILL IMMEDIATELY ADVISE MY COACH OR AN OFFICIAL OF LEAGUE          

                            OF THIS UNSAFE CONDITION AND WILL NOT PARTICIPATE UNTIL THE CONDITION IS CORRECTED.

                            I ASSUME ALL FOREGOING RISKS AND ACCEPT PERSONAL RESPONSIBILITY FOR THE DAMAGES FOLLOWING SUCH INJURY, PERMANENT DISABILITY, OR DEATH.

I RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE LEAGUE,  IT'S AFFILIATED CLUBS, THEIR RESPECTIVE ADMINISTRATORS, DIRECTORS, AGENTS, ATTORNEYS, COACHES, AND OTHER EMPLOYEES OF THE ORGANIZATION, OTHER PARTICIPANTS, SPONSORING AGENCIES, SPONSORS, ADVERTISERS, AND, IF APPLICABLE, OWNERS AND LESSORS OF PREMISES USED TO CONDUCT THE EVENT, ALL OF WHICH ARE HEREINAFTER REFERRED TO AS "RELEASEES", FROM DEMANDS, LOSSES, OR DAMAGES ON ACCOUNT OF INJURY, INCLUDING DEATH OR DAMAGE TO PROPERTY, CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HAVE READ THE ABOVE WAIVER AND RELEASE AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.  I ALSO AGREE TO ABIDE BY ALL RULES THAT IS OUTLINED IN THE EFFECTIVE RULEBOOK.

Any on or off-ice abuse from league players and or players booking events at Valley Ice Center, whether verbal or written (such as a phone call, letter, and/or e-mail) of Valley Ice Center staff including employees, league administrators, and or management can receive a suspension from league and/or rink activities/events or even a ban from the rink at the discretion of the General Manager.

 

 

Date:________________________                Players signature___________________________________