PLAYER REGISTRATION –
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 “
- SIGNED waiver
form.
- All Players MUST
register with
PLEASE PRINT CLEARLY
NAME:_________________________________________________________BIRTHDATE__________________
ADDRESS:________________________________CITY____________________________ST_____ZIP_______
HOME PHONE :________________________CELLPHONE:
_________________________________________
E-MAIL:_______________________________________________
˙ VISA ˙
M/C ˙ AMEX
CC #
_______________________________________ Exp
Date______________
Amount $____________________
Signature________________________________
(PLEASE CIRCLE ONE
OF THE FOLLOWING PAYMENT OPTIONS)
PAYMENT 1 PAYMENT
2 TEAM PAYMENT 1 TEAM
PAYMENT 2
- $490 due APR 9 - $290 due APR 9 - $5375 due APR 9 - $2760 due APR 9
$490 total due APR 9 - $215 due JUN 4 $5375 total due APR 9 - $2760 due JUN 4
$290 total due APR 9 $2760 total due APR 9
- 16 Regular
Season Games
- 3
Playoff Games
- Awards
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…
PLEASE READ CAREFULLY
WAIVER AND RELEASE OF
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:
1.
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.
2. 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.
3. I ASSUME ALL FOREGOING
RISKS AND ACCEPT PERSONAL RESPONSIBILITY FOR THE DAMAGES FOLLOWING SUCH INJURY,
PERMANENT DISABILITY, OR DEATH.
4.
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.
5. 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.
6.
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.
Date:________________________ Player signature_____________________________________