PLAYER REGISTRATION FORM
Sessions
*
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Monday, August 7, 2017
$
15.00
Friday, August 11, 2017
$
15.00
Both Sessions: Monday, August 7 & Friday, August, 11, 2017
$
25.00
Total
$
0.00
Player Name
*
First Name
Last Name
Date of Birth
*
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Month
-
Day
Year
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Emergency Contact
*
First Name
Last Name
Address
*
Street Address
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Phone Number
*
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*
Waiver and Release from Liability
I understand that my son or daughter will be participating in activities that involve serious risk of injury, including permanent disability and severe social and economic losses, which might result from their own actions, from the actions of others, from the rule of play, or from the condition of the competition area and/or the related facilities or equipment used in the activities in which they will be participating. I also understand that there may be other risks not known to me or not reasonably foreseeable at this time. I assume all of the forgoing risks and accept personal responsibility for any resulting injury, permanent disability or social and economic losses. I hereby release, waive and discharge "Quest Hockey Performance Company" D/B/A "Quest Hockey" composed of Matt Schwartz and Brandon Rubeo and their respective employees and representatives (collectively the "released parties") from, and agree not to sue any such released parties for, any claims demands, losses or damages which result on account of any injury, permanent disability or social or economic loss caused by, or alleged to have been caused by, in whole or part, any cause whatsoever, except for the sole negligence of any such released party. I have read this Waiver and Release from Liability and understand that I have given up substantial rights by agreeing to it. I have agreed to this Waiver and Release from Liability voluntarily, intending to be legally bound, and understand that my execution of this document is an express requirement for my son or daughter's participation in the Peters Township Hockey Clinic at the Iceoplex at Southpointe. This waiver and release shall remain in effect for all activities in which he or she participates on or after the date that I have executed this form. By checking the box, below, you acknowledge that you have read this Waiver and Release from Liability and agree to its terms.
Signature
*
I agree and have checked this box voluntarily, intending to be legally bound.
Media Waiver
I hereby consent and agree that Quest Hockey has the right to take photographs, videotape, or digital recordings of my son or daughter while participating in the Peters Township Hockey Clinic at the Iceoplex at Southpointe, and to use these in any and all media, now and hereafter known, for promotional purposes, to show video highlights to be used on www.QuestHockey.com and for various other uses on our social media outlets (Facebook, Twitter, Youtube, Instagram, etc.) and online accounts. I do hereby release to Quest Hockey all rights to exhibit this work in print or electronic form publicly or privately; I waive any rights, claims, or interest I may have to control the use of my son or daughter’s likeness in whatever media is used; I understand that there will be no financial or other remuneration for recording my son or daughter, either for initial or subsequent transmission or playback. By checking the box, below, you acknowledge that you have read this Media Waiver and agree to its terms.
Signature
*
I agree and have checked this box voluntarily, intending to be legally bound.
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