Mallards Hockey Club

Registration                                                                                                        

Participants Name  __________________________________   Age_____________    Phone #_______________________

Address  ___________________________________________  City _____________   Zip Code ______________________

E-Mail address _____________________________________   Hockey Experience  _______________________________

Camp registering for (please check)    □Full Ice Session I (Squirt)     □ Full Ice Session II (Squirt)   □Powerskating PeeWee         

□Powerskating Mite/Squirt           □ Full Ice Session I (Bantam)           □ Full Ice Session II (Bantam)           □Adult Summer

Waiver of Liability, Release, Assumption of Risk & Indemnifying Agreement                                    

 For and in consideration of participating with the Mallards Hockey Club and member team (hereafter club) and being allowed to participate in club events and member team activities, the participant relinquishes any and all liability for and cause of action for personal injury, property damage or wrongful death occurring to participant arising out of participation in club events or member team activities or the sport of ice hockey, or and activities incidental thereto, wherever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, and causes of action that participant may have are hereby relinquished and the participant does so on behalf of participant's heirs, executors, administrators and assigns.

 Participant acknowledges, understands and assumes all risks inherent in ice hockey and any team activities, and understands that said sport and activities involve risks to participant's person including bodily injury, partial or total disability, paralysis, and death, and damages which may arise there from and that I have full knowledge of said risks.  These risks and dangers may be caused by the negligence of the participant or the negligence of others, including the "releases" identified below.  It is further acknowledged that there may be risks and dangers not known to use or are not reasonably foreseeable at this time.

 Participant acknowledges, understands and assumes the risks, if any, arising from the conditions and use of ice hockey rinks and related premises and acknowledges and understands that included within the scope of this waiver and release is any cause of action, arising from the performance, or failure to perform maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said rinks, for negligent selection of certain releases, or negligent supervision or instruction by releases.

 It is the purpose of this agreement to exempt, waive and relieve releases from liability for personal injury, property damage, and wrongful death caused by negligence, including the negligence, if any, of releases.

 "Releases" include the Mallards Hockey Club, member teams, event hosts, other participants, coaches, officials, sponsors, advertisers, owners and operators of the premises used to conduct any event and each of them, their officers, directors, agents and employees.

 Participant agrees if any claim for participant's personal injury or wrongful death is commenced against releases he shall defend, indemnify and save harmless releases from any and all claims or causes of action by whomever or wherever made or presented for participant's personal injuries, property damage or wrongful death.

 Participant acknowledges that he has been provided and has read the above paragraphs and has not relied upon any representations of releases, that he is fully advised of the potential dangers of ice hockey and understands these waivers and releases are necessary to allow amateur ice hockey to exist in its present form.

 By signing below, the participant agrees to all of the above statements.

Participant’s signature (parent / guardian signature for participants under 18 years)      date signed

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