Have a Go at Broomball

Have a Go at Broomball

5 pm, August 3 2024 at Erina Ice Arena.
Please arrive no later than 45min prior to the start of the session to allow time for an off ice briefing of the game and to be fitted with equipment.
Participant's Name*

First NameLast Name
Parent's Name (if under 18)

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact Number*

Area CodePhone Number
Postcode*
Date of Birth*

MonthDayYear
Please note: Participants need to be at least 15 years old
YesNo
Yes, acknowledging as the participantYes, acknowledging as the parent/guardian of the participant
By checking 'I Agree' below and submitting this form, you, the parent or guardian (if participant is under 18), agree to release Erina Ice Arena, including instructors and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any rink lesson or activity. You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury. You give permission for emergency medical transportation and treatment at your expense should the need arise.*

I agree
Should be Empty: