3 on 3 Ball Hockey Tournament Waiver - 2024

PLAYER CONSENT/PERMISSION FORM FOR 3 ON 3 BALL HOCKEY TOURNAMENT – SATURDAY JUNE 22, 2024 AT THE NEW SAREPTA AGRIPLEX

THIS FORM MUST BE READ AND SIGNED BY A PARENT OR GUARDIAN OF EACH PLAYER.

ACTION:

New Sarepta Minor Hockey Association in conjunction with the New Sarepta Agricultural Society is hosting a 3 on 3 Ball Hockey Tournament on Saturday, June 22, 2024, at the New Sarepta Agriplex on the non-ice arena surface. Participants must wear safety equipment while playing including a hockey helmet with cage and gloves. Shin pads are highly recommended.

Each player must pay a $35 registration fee.

Parents are responsible for supervising their children throughout the day. Physical activities such as a ball hockey tournament involve certain elements of risk. Personal injury, including serious injury up to and including loss of life may occur. The risk of sustaining these types of injuries results from the nature of the activity and can occur without fault of either the player, New Sarepta Minor Hockey Association, New Sarepta Agricultural Society and its employees/agents/volunteers or the facility where the activity takes place. By choosing to allow your child to take part in the 3 on 3 ball hockey tournament, you are accepting that your child may be exposed to risks.

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Full Name of Player:

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Team Name:

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In the event of an emergency, we can contact (Full Name):

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Emergency Contact Phone Number: *

WE HAVE READ THE ABOVE AND WE UNDERSTAND THAT BY PARTICIPATING IN THE ACTIVITY AS DESCRIBED, WE ARE ASSUMING THE RISKS ASSOCIATED WITH DOING SO. THE ABOVE NAMED CHILD HAS PERMISSION TO PARTICIPATE IN THE 3 ON 3 BALL HOCKEY

TOURNAMENT ON JUNE 22, 2024.

**BY ENTERING YOUR NAME BELOW YOU AGREE TO THE ABOVE WAIVER ON BEHALF OF YOUR PLAYER/CHILD

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DATE SIGNED: *
A copy of your responses will be emailed to the address you provided.
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