ADHSHL TEAM STAFF AND VOLUNTEER REGISTRATION

1
Name* This field is required.
First Name
Last Name
2
PLEASE NOTE: You must have a 2024-25 USA Hockey number in order to complete this registration.
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.
5
USA Hockey #* This field is required.Must be for the 2024-25 Season (the 4th digit in your USA Hockey number must be "5")
6
ADHSHL Team
Please Select
Please Select
Beach Cities
Bishop Amat
Canyon
Capistrano
Carlsbad
Central Cathedral
Corona Norco
Damien
Edison
Fairmont
Girls Team - Inland Empire
Girls Team - Irvine
Girls Team - LJCD
Girls Team - Los Alamitos
Inland Empire
Irvine
JSerra
La Jolla Country Day
Los Alamitos
Mater Dei
North County
Ontario
Orange Lutheran
Pacific Ridge
PYL
Poway
Saddleback
San Diego
Santa Margarita
Servite
St John Bosco
Villa Park
Yorba Linda
League Admin (ADHSHL)
ADHSHL Team
League Admin (ADHSHL)
Coach
Manager
Locker Room Monitor
Other
Staff Position
7
Team Staff and Volunteer Agreement* This field is required.I understand and agree to the following as conditions of participation as a team representative for the 23-24 season:I understand that I must always complete and maintain current, the registration requirements for my position as spelled outin the TEAM STAFF AND VOLUNTEER REGISTRATION REQUIREMENTS. I also understand that I must complete all necessary requirements prior to my participation. I understand that my actions are subject to the USA Hockey Playing Rules, Guidebook and Codes of Conduct and by the rules andregulations set forth by CAHA, SCAHA, IIF, the ADHSHL, The Rinks and Great Park Ice (as applicable for my position) and that regardless of my knowledge of the same, I understand that my actions will be gauged by their content and agree to conduct myself accordingly.I have reviewed, understand, and agree to be bound by the USA Hockey Code of Ethics. I understand that violations of the Ethics Code may result in the full or partial forfeiture of my privileges in programs sanctioned by USA Hockeand/or its various affiliates. I further understand that lack of awareness or a misunderstanding of an ethical standard on my part is not a defense to a charge of unethical conduct.I will conduct myself in a manner conducive to good sportsmanship by refraining from abusive, obscene, or threatening languageor gestures, physical violence, and any behavior that would be considered unsportsmanlike or would disrespect the game, its players, coaches, officials, parents, or spectators.I understand that I am a role model to youth and young adult players and ensure my actions both on and off the ice are appropriate.I understand that I must always follow the SafeSport guidelines to ensure the safety of all minor children.Resolution of disputes shall be in accordance with and subject to the applicable bylaws, rules and regulations of The Rinks,Great Park Ice, IIF, ADHSHL, SCAHA, CAHA, and USA Hockey as they apply to my position.I understand that, subject to an applicable hearing, any failure to comply with these conditions could subject myself toimmediate suspension, fines, and/or the revocation of my privilege as a Team Representative.CONCUSSION PROTOCOL: I understand that the Pacific District of USA Hockey has adopted concussion-related education,awareness, and protocol into their policies and procedures. I understand the following guidelines and protocol exist and will respect them if they must be instituted for anyindividual on the team. o An athlete who is suspected of sustaining a concussion or head injury shall be immediately removed from participation forthe reminder of the day. Removal can be at the request of a coach, official, team manager, parent/guardian, or the athlete.o Athlete shall not be permitted to return to participation until he/she is evaluated by a medical professional trained in the management of concussions and acting within the scope of his/her practice. Acceptable evaluators should be medical professionals with one of the following medical license designations: MD, DO, Neurologist, Neuropsychologisto The athlete shall not be permitted to return to participation until he or she provides the approved and completed ConcussionRelease form to its member program (head coach, team manager, or registrar)Should it be determined that an athlete needs to be removed from participation, I understand that the protocol outlined hereinshall be followed for the safety of the athlete.I understand that if a suspected concussion has occurred and protocol has been enacted for an athlete, there is no reviewperiod or negotiation as to the course of action and return to participation outside of the recommendations of the evaluating medical professional who has been selected to treat the athlete.
8
THE RINKS / GREAT PARK ICE / LEAGUES & TEAMS CONSENT, INDEMNIFICATION, WAIVER AND RELEASE AGREEMENT* This field is required. FOR AND IN CONSIDERATION of my and, if a child’s name is written below (“My Child”), My Child’s participation in activities related to the Jr. Ducks, Lady Ducks, Jr. Gulls, Jr. Gulls Girls, Anaheim Ducks High School Hockey League and/or Orange County High School Hockey League (individually and collectively, the “Teams”) and/or being at and/or using of any of the premises and facilities commonly known as Great Park Ice or The Rinks (individually and collectively, the “Facility”), including transportation to and from, and any equipment supplied to me or My Child or used by me or My Child in connection therewith (collectively, “Participation”), all as applicable and to the fullest extent permitted by applicable laws, I agree as follows: 1. I acknowledge that the risk of exposure to or transmission of bacteria and viruses exists in any place where people are gathered. By engaging in the Participation, including, for example, entering the Facility, I voluntarily assume on my behalf and on behalf of My Child all risks of such exposure. I agree to abide by, and ensure My Child abides by all rules, suggestions and guidelines of the Facility. Facility has not made, and I am not relying upon, any representation or warranty, express or implied, that the Facility or any employees, patrons, guests or employees are free from bacteria and/or viruses or that any particular precautions, actions, preventions or disinfecting in and around the Facility is effective in the prevention of or exposure to bacteria and/or viruses. I agree that I (or My Child) will not engage in the Participation, including for example, entering the Facility, if I (or My Child) have a communicable disease or illness, is suspected to have or exhibits or experiences communicable disease or illness symptoms and shall notify the applicable Facility and Teams (as and if applicable) of such symptoms or if I am (or My Child is) found to have a communicable disease or illness within fourteen (14) days prior to or after the Participation. Facility reserves the right to condition or refuse entry to me or My Child based upon information received or upon guidelines or requirements provided by governmental authorities and agencies (including without limitation, the Centers for Disease Control and Prevention), industry recommendations, or otherwise pursuant to Facility’s own guidelines, regulations or independent determination. If requested, including without limitation, prior to and as a condition of entering the Facility, I consent to health screenings by a representative or agent of Facility, including without limitation, temperature measurement and health questionnaires.2. In addition to Section 1, above, I acknowledge and I am aware of the hazards, dangers and risks (inherent or otherwise) in connection with the Participation and being a spectator, including, without limitation, exposure to or transmission of bacteria and viruses, property damage, property loss, property theft, economic loss, accident, minor injury or serious injury (known or unknown), which may include permanent disability or paralysis, or death to me, My Child, to other participants, to spectators or other third parties (collectively, “Injury”). I further acknowledge that there are natural factors and occurrences which may impact or affect the safety of the Participation. I warrant that I am, and My Child is, in good health and has/have no physical conditions that would prevent me or My Child from being involved in or acting in connection with the Participation. 3. I assume full responsibility for, and all risk of, any illness, accident, bodily injury, death, property loss, property theft or property damage that may result for any reason, including by acts of negligence, in connection with the Participation and being a spectator, whether caused by Irvine Ice Foundation, Ice Management, LLC, Irvine Roller Rink, LLC, San Diego Gulls Hockey Club, LLC, the Facility, and/or its parent, related affiliate, agent, successor and/or subsidiary companies (and/or their respective owners, officers, directors, members, employees, agents, subtenants, ground lessors, landlords and/or sublandlords) (collectively, the “Releasees”), me, My Child, another participant, any third persons or otherwise.4. I agree that prior to participating, or allowing My Child to participate, in any activity relating to the Participation, including, without limitation at the Facilities, I will inspect the premises and surrounding area and all equipment to be used. If through my inspection I determine that anything related to the Participation is unsafe, I will immediately advise an official of the applicable Facility and Teams (as and if applicable) of the unsafe condition and will not participate, or allow My Child to participate, until the condition is corrected.5. If I or My Child become injured or Ill as a result of the Participation, I authorize the Releasees to administer, or cause and consent to the administration of, whatever first aid, medical care, dental care or other treatment and medications as may be necessary under the circumstances, including treatment by a physician, emergency medical technician, dentist or hospital (“Treatment”), although I acknowledge that the Releasees have no obligation to do so and that the Releasees do not endorse the services of any physician or hospital that may provide such Treatment to me or My Child. I understand that I will be financially responsible for the cost of any such care, treatment or medication and that the Releasees will have no obligation to pay any such costs of any Treatment and agree to reimburse the Releasees for any such costs incurred.6. I RELEASE, AGREE NOT TO SUE AND AGREE TO INDEMNIFY AND HOLD HARMLESS (ON BEHALF OF MYSELF AND MY CHILD) THE RELEASEES of and from any and all claims, causes of action, suits, demands, damages, losses, liabilities, costs, expenses and any actions of any kind whatsoever (collectively, "Claims"), known or unknown, existing now or in the future, that I, My Child, our respective heirs, executors, administrators, next of kin, assigns or any third party may now or hereafter have against the Releasees, arising in any way as a result of or in connection with the Participation and any Treatment, including, without limitation, any Injury suffered by me, My Child, our respective heirs, executors, administrators, next of kin and assigns or any other party and regardless of any fault or passive or active negligence on the part of the Releasees, myself , My Child, or any third party. I (on behalf of myself and My Child) expressly waive and relinquish all rights and benefits afforded by California Civil Code Section 1542 and do so understanding and acknowledging the significance of this specific waiver of Section 1542. Section 1542 states as follows:“A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS THAT THE CREDITOR OR RELEASING PARTY DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE AND THAT, IF KNOWN BY HIM OR HER, WOULD HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR OR RELEASED PARTY.”7. I grant to the Releasees, and any person or entity acting under the Releasee’s permission or with the Releasee’s authority, permission to photograph, film, videotape or record me or My Child while at the Facility, and a non-exclusive license to use the likeness, image, photograph and name of me and My Child for any and all commercial and non-commercial purposes in perpetuity including, without limitation, in connection with the marketing, promotion and/or advertising of the Facility, the Teams, the Anaheim Ducks, the San Diego Gulls, the Releasees, and/or their affiliates and their respective programs in any media known and unknown or hereinafter developed without geographic or time restrictions. I acknowledge that events held at the Facility may be recorded and broadcasted through various means, including through live streaming by the Facility or the Facility’s authorized vendors.8. This Agreement constitutes my entire understanding regarding the subject matter of this Agreement and supersedes any prior statements, agreements or representations (written or oral) regarding that subject matter. No oral representations, statements or inducements apart from this Agreement as written have been made to me. I agree that this Agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, such invalidity will not affect any other provision that can be given full effect without the invalid provision. 9. BINDING ARBITRATION: This Agreement and any dispute or Claims whatsoever between me (or My Child) and the Facilities, Teams and Releasees, including, without limitation, my or My Child’s Participation and any Injury or Treatment, shall be governed by and construed in accordance with the internal laws of the State of California exclusive of conflict or choice of the law rules and, subject to the following provision related to arbitration of disputes, the parties consent to the exclusive jurisdiction of the Superior Court of the State of California for the County of Orange. Any dispute or Claims between me (and/or My Child, as applicable) and the Facilities, Teams and Releasees, including without limitation, arising out of or relating to this Agreement, my or My Child’s Participation, any Injury, any Treatment and the determination of the scope or applicability of this agreement to arbitrate, shall be determined by arbitration in Orange County, California before one arbitrator. The arbitration shall be administered by JAMS pursuant to JAMS’ Streamlined Arbitration Rules and Procedures. The arbitration proceedings and award shall be confidential, except as otherwise required by court order or as necessary to confirm, vacate or enforce the award and for disclosure in confidence to the parties’ respective attorneys, advisors and family members. Judgment on the award may be entered in any court having jurisdiction. This provision shall not preclude a party from seeking provisional remedies in aid of arbitration from the Superior Court of the State of California for the County of Orange. Each party shall bear its own costs and fees of arbitration.10. I have carefully read this Agreement, and I know and understand what it means, including that it is a complete waiver and release of liability, a waiver of a jury trial and promise on behalf of myself and My Child to indemnify and not to sue or make a claim. My signature below is my own free and voluntary act and I intend this Agreement to be legally binding on me. I certify that I am at least 18 years old.11. I represent, if this waiver is for My Child, that I am a parent and natural guardian of My Child and that I am, in fact, acting in such capacity and agree to save and hold harmless and indemnify the Releasees from all Claims, whether known or unknown, which may be made against the Releasees because of any defect in or lack of such capacity to so act and hereby release the Releasees on behalf of My Child and other his/her parent(s) or legal guardian(s).
9
CODE OF CONDUCT AND ASSUMPTION OF RISK* This field is required.BY ENTERING THE FACILITY, SKATERS, GUESTS AND SPECTATORS ACKNOWLEDGE THAT THEY UNDERSTAND AND AGREE TO ALL OF THE FOLLOWING: 1. Read and abidee by all posted rules, signs, warnings, and policies and cooperate with staff 2. All skaters are required to pay for their skating time prior to entering rink surface. 3. Except for children enrolled and actively participating in a skating or hockey program at the Facility, children must be accompanied by a responsible adult at all times. Parents are responsible to ensure their children adhere to this Code of Conduct and all Facility rules. 4. Respect all those at the Facility. Do not physically or verbally threaten or harass any person, including any other skater, spectator, official, coach, or staff member, including through any social media platform. Fighting, use of physical force, obscene, offensive, or otherwise inappropriate language or gestures, or racial, religious or ethnic slurs are prohibited. 5. Do not possess or use any item that could be used as a weapon, including, but not limited to: firearms, explosives, fireworks, chemical dispensing devices, or any clubs, sticks, knives or other object(s) that may be used in any way to inflict bodily injury on another person. Hockey sticks and other hockey and/or ice skating equipment are permitted, as long as such items are used for their intended purpose. 6. Do not throw or leave objects on the rink surface. 7. Everyone enjoys the Facility when it’s clean. Do not discard litter of any kind anywhere, including on the rink surface, except in designated trash receptacles. Rummaging through or removing items from the trash receptacles is prohibited. Spitting is prohibited. 8. Respect the property of others. Do not deface, damage or destroy any property belonging to the Facility, its occupants or other persons in the Facility. 9. Do not lean over or pound on the glass surrounding the rink surface. 10. Do not bring any outside food or alcoholic beverage into the Facility, unless otherwise approved by the Facility. 11. Do not take any food or beverages onto the rink surface or place food or beverages on the surrounding dasherboards or any railings. 12. Alcoholic beverages are permitted if purchased from the Facility and only in areas specifically designated for the consumption of alcohol. 13. Smoking or consuming tobacco (including e-cigarettes and vaporizers) and/or marijuana, are prohibited. Drug paraphernalia and illegal substances are prohibited. 14. Skating is not permitted under the influence of drugs, alcohol, or other controlled substances. 15. Do not stay on or enter rink surface when resurfacing/cleaning or maintenance is taking place. 16. Keep exits to the rink surface clear. Before getting on the rink surface, look for oncoming skaters. 17. Do not sit on floors, rink surface, dasherboards, handrails, stairs, trash receptacles or other areas not specifically designated for seating. 18. Be safe. Do not act in a manner that may cause or contribute to injury to yourself or any other person. 19. Be aware of all surroundings while on and off the rink surface as objects, such as hockey pucks and sticks, may leave the rink surface at any time. 20. No electronic devices are allowed on the rink surface. 21. No talking or texting on mobile devices while on the rink surface. 22. Do not use headphones/earbuds while on the rink surface during public skate sessions or hockey activities. 23. Do not bring any animals into the Facility with the exception of service animals (as defined by the Americans with Disabilities Act (“ADA”)). 24. Inform a Staff member if you require accommodations or assistance, we’ll be happy to assist. 25. Do not violate any federal, state or local law or ordinance.
Should be Empty: