4on4_register
Player's Name
*
First Name
Last Name
Birth Year
*
Please Select
08
09
10
11
12
Current Level of Play
Please Select
Rep
Roster Select
House League
Position
Please Select
Forward
Defense
Street address
*
(do not use commas)
Town/City
*
(do not use commas)
Postal Code
*
Telephone1
*
-
-
Telephone2
-
-
E-mail address
*
Medical information
(do not use commas)
Parent 1 name
*
First Name
Last Name
Emergency Contact 1 Name
*
First Name
Last Name
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.
*
Yes, I have read the Waiver Terms and Refund Policy and agree to their terms.
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