D Division individual player registration
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3 - Jersey # Requests
For and in consideration of participant’s registration with Puck Cancer, Inc., its Affiliate, and rinks and being allowed to participate in Puck Cancer events and member team activities, the parent(s) or legal guardian(s) of participants relinquish any and all liability for any cause of action for personal injury, property damage or wrongful death occurring to the participant arising out of participation in Puck Cancer events, member team activities, the sport of ice hockey, and/or activities incidental thereto, whenever 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 (or parent(s)/guardian(s)) does(do) so on behalf of my/our and participant’s heirs, executors, administrators and assigns.
Participant and/or participant’s parent(s)/guardian(s) acknowledge, understand and assume all risks inherent in ice hockey and any member team activities, and understand 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 therefrom and that I/we 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 “releasees” identified below. It is further acknowledged that there may be risks and dangers not known to us or are not reasonably foreseeable at this time. I/ We agree to abide by and be bound under the rules of Puck Cancer. Rules can be found on the Puck Cancer website or are available upon request.
Participant and/or participant’s parent(s)/guardian(s) acknowledge, understand and assume 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 releasees, or negligent supervision or instruction by releasees.
Participant or participant’s parent(s)/guardian(s) agree if any claim for participant’s personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless releasees 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.
It is the purpose of this agreement to exempt, waive and relieve releasees from liability for personal injury, property damage, and wrongful death caused by negligence, including the negligence, if any, of releasees. ‘Releasees’ include Puck Cancer, Inc., its Affiliate Associations, Local Associations, 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 and/or participant’s parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers of ice hockey and understand these waivers and releases are necessary to allow amateur ice hockey to exist in its present form.
Electronic Signature (by signing this form you agree to the above Release and Waiver of Liability)
Once "Submit" is clicked you will be directed to a payment page.
Puck Cancer 501(c)(3) Tax ID# 46-4555013
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