Summer 2023 Goalie Camps

Player's Name

First NameLast Name

Select Event

Address

Street Address

Street Address Line 2

CityState

Zip Code

Birth Date

MonthDayYear

Gender

Parent/Guardian Information

Name

First NameLast Name

Home Number

Area CodePhone Number

Cell Number

Area CodePhone Number

E-mail

Any medical conditions? If yes, please describe.

Does the player have an inhaler? If yes, please explain any instructions.

Liability Waiver

I, the parent/guardian, acknowledge:

1. Hockey is a contact sport and, while a "no body-checking" policy is in place, there is an inherent risk when playing hockey. I am authorized and am granting permission for my child to participate in this and other Red River Valley 3-on-3 Hockey events.

2. Red River Valley 3-on-3 Hockey is not responsible for accidents, injuries, or damage, however caused, resulting directly from the participation of my child in a Red River Valley 3-on-3 Hockey event, whether incurred on the ice or otherwise in or about the buildings at any time preceding, during, or subsequent, to the event.

3. I hereby am authorized to discharge all agents and employees from all actions, claims, and demands I may have for any such injury and/or damage.

I have read, understand, and agree to comply with the Liability Waiver as outlined above.

Medical Waiver

I, the parent/guardian, acknowledge the health and safety of each child should be considered, first and foremost, prior to participation in hockey related activities.

Medical Condition

My child does not have a medical condition that would prevent him/her from participation in this and other Red River Valley 3-on-3 Hockey events.

Medical Emergency

In the case of a medical emergency, I am authorized and grant permission to the doctor or medical attendant to examine my child, make the necessary diagnosis, and administer treatment as required.

I have read, understand, and agree to comply with the Medical Waiver as outlined above.

Photography Authorization

I, the parent/guardian, am authorized to grant permission to Red River Valley 3-on-3 Hockey to post, share, and/or tag photographs and/or videos of my child taken during their participation in this event, on the Red River Valley 3-on-3 Hockey website or social media applications.

I have read, understand, and agree to comply with the Photography Authorization as outlined above.

Confirmation

BY ACKNOWLEDGING AND SUBMITTING FORM BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.