Wednesday, June 10, 2009
Monday, May 25, 2009
Wednesday, May 13, 2009
Monday, January 12, 2009
Thursday, January 8, 2009
Player Registration Form for 2009 Season
Blue Thunder Hockey Development
Please Print Participant Registration Form Please Print
Participant’s Name__________________________________________
Parent/Guardian_____________________________________________
Mailing Address_____________________________________________
Town_______________________________ Postal Code ____________
Telephone (Home)____________ _Work __________ Cell__________
Email address__________________________________________
Winter Hockey Team ____________________________________
Position(s) ____________________________________________
Age ____ Birthdate _______________ Health Card No. __________________
Medical Information
1. Significant medical condition (epilepsy, diabetes, orthopedic problems, dangerous allergies)?
2. Head, back, joint injuries (in the past two years)?
3. Medication taken regularly (excluding vitamins)?
4. Other: Any medical condition that should be known by the Club, Team
or Coaching Staff?
Waiver and Release of Liability
In consideration of being allowed to participate in any way in the Canadian Summer AAA Hockey Association Inc. Blue Thunder Hockey Development athletic/sports program, related events and activities, the undersigned acknowledges, appreciates and agrees that:
the risk of injury from the activities involved with this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury does exist; and
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASERS or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Canadian Summer AAA Hockey Association Blue Thunder Hockey Development their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors and, if applicable, owners and leesers of premises used to conduct the event (“Releases” . WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND AND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT.
FOR PARTICIPANTS OF MINOR AGE
(under 18 at the time of registration)
This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in this program as provided above.
X __________________________________________ (Participant’s Name)
X __________________________________________ (Parent/Guardian’s Signature)
X __________________________________________ (Emergency Phone Number)
X __________________________________________ (Witness)
Date Signed:__________________________________
Please Print Participant Registration Form Please Print
Participant’s Name__________________________________________
Parent/Guardian_____________________________________________
Mailing Address_____________________________________________
Town_______________________________ Postal Code ____________
Telephone (Home)____________ _Work __________ Cell__________
Email address__________________________________________
Winter Hockey Team ____________________________________
Position(s) ____________________________________________
Age ____ Birthdate _______________ Health Card No. __________________
Medical Information
1. Significant medical condition (epilepsy, diabetes, orthopedic problems, dangerous allergies)?
2. Head, back, joint injuries (in the past two years)?
3. Medication taken regularly (excluding vitamins)?
4. Other: Any medical condition that should be known by the Club, Team
or Coaching Staff?
Waiver and Release of Liability
In consideration of being allowed to participate in any way in the Canadian Summer AAA Hockey Association Inc. Blue Thunder Hockey Development athletic/sports program, related events and activities, the undersigned acknowledges, appreciates and agrees that:
the risk of injury from the activities involved with this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury does exist; and
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASERS or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Canadian Summer AAA Hockey Association Blue Thunder Hockey Development their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors and, if applicable, owners and leesers of premises used to conduct the event (“Releases” . WITH RESPECT TO ANY AND ALL INJURY DISABILITY, DEATH or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND AND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT INDUCEMENT.
FOR PARTICIPANTS OF MINOR AGE
(under 18 at the time of registration)
This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in this program as provided above.
X __________________________________________ (Participant’s Name)
X __________________________________________ (Parent/Guardian’s Signature)
X __________________________________________ (Emergency Phone Number)
X __________________________________________ (Witness)
Date Signed:__________________________________
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