Galactic Ice Adult Hockey League

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PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Home Phone:

* Email:

* Which Division?:

Competitive Upper Division

Competitive Lower Division

Recreational Division

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

WAIVER INFORMATION

In consideration of being allowed to participate in ice hockey programs (“Programs”) at Galactic Ice Rink (the “Facility”), the Participant, do hereby agree, to the fullest extent permitted by law, as follows:
1) TO WAIVE ALL CLAIMS that they have or may have against the Facility arising out of the Participant’s participation in the Programs and/or the use of any equipment provided by the Facility (“Equipment”). The Participant specifically understand that they are releasing any and all claims that arise or may arise from any negligent acts or conduct of the Facility, its owners, affiliates, operators, employees, agents, and/or officers.
2) TO ASSUME ALL RISKS of participating in the Programs and using the Equipment, even those caused by the negligent acts or conduct of the Facility, its owners, affiliates, operators, employees, agents, and/or officers. The Participant understand that the risks of participating in the Programs and using the Equipment may be both foreseen and unforeseen and include serious physical injury and/or death;
3) TO RELEASE the Facility, its owners, affiliates, operators, employees, agents, and/or officers from all liability for any loss, damage, injury, death, or expense that the Participant (or his/her next of kin) may suffer, arising out of his/her participation in the Programs and/or use of the Equipment

I agree with the above *

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