PETERBOROUGH FUN 4 on 4 League

Player's Name*

Last NameFirst Name

Position*

Division registering in: *

Home Telephone*

Cell Telephone

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Level Played Last Season*

Date of Birth

Please enter in this format only YYYY-MM-DD

E-mail address*

example@example.com

Secondary Email Address

example@example.com

Medical information

(do not use commas)

Request for teammate:(ONE ONLY and must be a reciprocal request upon registration. Email / Phone requests at a later date will not be accepted)

Parent Name*

First NameLast Name

Players that wish to move up a divison must submitted in writing and approved by Overtime Hockey Staff.

ALL AAA and AA players must register in the divison above.

Please check if you are interested in being a

CoachTrainer

Please check certifications you hold

Waiver terms and refund policy approval*

WAIVER CLAIM - Acknowledging that there is a risk associated with participation in any sport, I, the legal parent or guardian of the participant, agree that OVERTIME Hockey Company Inc, its agents, servants, employees, and consultants will not be responsible for any accident, damage, injury or loss, however caused, negligent or otherwise, at any time and expressly release any and all of the aforementioned parties from all claims arising from any accident, damage, injury, or loss or as a consequence thereof. I understand that my said agreement, release and discharge, shall bind my heirs, legal representatives and assigns and shall inure to the benefit of OVERTIME Hockey Company Inc, its agents, servants, and consultants and their successors and assigns. I acknowledge that OVERTIME Hockey Company Inc strongly recommends that my son/daughter have a physical examination by a doctor to ensure he/she is in good health and fully physically able to participate in the vigorous activity of ice hockey. In the event that my son/daughter is injured during the operation of OVERTIME Hockey Company programs, I give my permission for transportation as needed to a medical practitioner / facility at my expense. I agree that all photographs acquired during the operation of the league become the property of OVERTIME Hockey Company Inc and may be used for promotional purposes. &#13;&#10;&#13;&#10;REFUND POLICY&#13;&#10;Only in the event of uncontrollable circumstances that prohibit a player from continuing or participating in OVERTIME Hockey Company Inc programs &#13;&#10;&#13;&#10;Uncontrollable Circumstances&#13;&#10;&#13;&#10;-Season or Program Ending Injury&#13;&#10;-Residence Relocation &#13;&#10;&#13;&#10;The refund will consist of a prorated portion of the registration fee (minus a $40 administrative fee) following notification of the Director.&#13;&#10;&#13;&#10;If a player registers and chooses not to participate before the start of Program, a refund will NOT be issued. ALL registrations are final.&#13;&#10;&#13;&#10;If the Season is affected by COVID-19 Pandemic, all players will receive a refund, if a minimum of 50% of the season can't be saved. Fee’s will be Prorated based on the number of program ice times.&#13;&#10;&#13;&#10;Season or Program Cancellations.&#13;&#10;In the event that a Season or Program(s) are affected by uncontrollable circumstances, Full refunds will be given. &#13;&#10;&#13;&#10;Uncontrollable Circumstances&#13;&#10;&#13;&#10;-Pandemics &#13;&#10;-Arena Availability &#13;&#10;-Program Availability

Yes, I have read the Waiver Terms and Refund Policy and agree to their terms.

4on4_register

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