PLAYER REGISTRATION - UFLAND LEAGUE: SUMMER 2010     

 

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

 Full payment towards dues by FIRST GAME (Checks Payable to “Valley Ice Center”).   All Players MUST have current USA hockey insurance.  Please REGISTER FOR USA HOCKEY ONLINE.  USA Hockey Membership expires August 31, 2010!

                                  

                                                                     PLEASE PRINT CLEARLY    

NAME: __________________________________________________________BIRTH DATE____________________________________

ADDRESS:__________________________________________CITY________________________________ST________ZIP__________

HOME PHONE :__________________________________________ WORKPHONE: _________________________________________

CELL PHONE: ___________________________________________ E-MAIL: _______________________________________________

 

LEVEL________________________________TEAM NAME __________________________________________________________

 

 

   Valley Ice Center  UFLAND ADULT SUMMER 2010     ˙   PLAN I - PAYMENT IN FULL -

                                                                                                              TOTAL PAID IN FULL-$410.00      

˙ VISA            ˙ M/C             ˙ AMEX                                

               

CC # _______________________________________          

                                                                                               

Exp Date______________                                                                ˙  GOALIE’S & REPS SPECIAL PRICE  -

                                                                                                                           TOTAL PAID IN FULL- $205.00

                                                                                                                               

Amount $____________________                                                                                                                                                                                                                                                                                                  

 Signature________________________________                                                                                                                                                                                                                                                                                4-ON-4 LEAGUE DUES COVER:

                                                                                                                                              l 12 Regular Season + Playoff Rounds

           l Awards for championship team members

REFUNDS: There will be no refunds!                                                                          

*ALL PLAYERS MUST MAKE A PAYMENT                                                          

AT THE START OF THE FIRST GAME OR THEY WILL NOT BE

ALLOWED ON THE ICE. NO EXCEPTIONS!!!

                                               

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 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/ ADULT HOCKEY LEAGUE (HEREBY REFERRED TO AS "LEAGUE")

                   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 AS OUTLINED IN THE EFFECTIVE RULE BOOK.

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_____________________________________