Vankoughnet Cup 2013 Registration/Waiver

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WAIVER, RELEASE AND INDEMNIFICATION:
The undersigned (on behalf of the participant if the participant is under 18 years of age) forever generally and completely release and discharge and shall indemnify and hold harmless the Vankoughnet Cup organizers, volunteers and fellow players against and from any and all claims and demands of every kind and nature whatsoever, for damages or injuries, actual or consequential, past, present or future, arising out of or in any way related to the Vankoughnet Cup 3 on 3 Shinney tournament, including but not limited to any claims of injury from participating in the tournament, the loss of personal property by theft or otherwise during the tournament. The undersigned acknowledges that of his/her own free will has chosen to participate in the tournament and related activities. I understand and acknowledge that the aforementioned activities carry with them a high level of risk of injury and additional hazards related thereto. I certify that I am aware of, and accept, these increased risks and that I am mentally and physically prepared for the risks associated with the Vankoughnet cup 3 on 3 shinney tournament. This general release shall further apply to all unknown, unanticipated, unsuspected, and undisclosed claims, demands, liabilities, actions or causes of action, in law, equity or otherwise. This Waiver shall bind the heirs, personal representatives, and successors of the undersigned, and inure to the benefit of the Event Organizers, volunteers and fellow players.

*This Waiver must be completed in full before the participant may participate in the Vankoughnet Cup

Participant information

First Name *

Last Name *

AGE OF PARTICIPANT *

DATE OF BIRTH *

Important medical information including allergies, breathing conditions or other

This information will be used in the event of a medical emergency.

Home Phone # *

Division *

Team Name *

Recreational team name also?

If you are playing in both competitive and family division, please select competitive above and put your rec team name here. If you are only playing in the Family division, just select that and put your team name in the "Team Name" box above.

Parent or Guardian may complete the following information

First and Last name of Parent or Gaurdian

Please fill this section out if participant is Under 18

Mobile phone # *

Your mobile phone # will be used to send alerts game day. We will not use this number for any other purpose unless requested.

Email address *

Your email address will be use to verify that the form was filled out by the person indicated on this form. 2013 Vankoughnet Cup updates and info will also be sent to your email address.

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