Roller Hockey Canada Insurance Waiver Form
Roller Hockey Canada Mandatory League Rules
1. Unless the player has thoroughly read through and signed this form and is registered with the
league, coverage is not provided for:
a. Liability insurance
b. Health, medical and dental insurance.
2. The league, and its organizers will in no way be responsible for:
a. Property damage caused by any player,
b. Loss, damage or theft of personal property, eyeglasses or contact lenses,
c. Personal injury, death, or loss of wages occurring from participation in the league.
3. Registration: It is the responsibility of each team captain/coach to ensure that each member of the team is made aware of the league’s conditions and rules and has completed this registration form prior to playing in the league.
4. Property Damage: The player will be held responsible for any damages to the dressing rooms, arenas, arena properties, or any one else’s personal belongings and also for any intentional harm inflicted on anyone else.
5. Adequate Equipment: The player is solely responsible for ensuring that they have adequate equipment and for the proper maintenance and up-keep of the equipment.
6. No-Contact: No checking, elbowing, slashing, or any other form of physical contact allowed. Minor jostling for the puck on boards when allowable when body contact kept to a minimum. Team Captains/Coaches are responsible for disciplining players for un-sports-man-like conduct during the game. Penalties will be called by referees for disregard of league rules.
7. Injuries: If a player is injured during play, Team Captain/Referee or league official is to immediately stop play and attend to the injury. If necessary, First-Aid will be called or a designate will transport injured player to Hospital as required.
8. Record Keeping: All records are kept by score keeper or referee if applicable.
9. Alcohol: Per Arena Rules, we do not allow or condone alcohol use either inside or outside of the arena.
10. Fighting: Fighting is not permitted. Refer to League by-laws for confirmation of disciplinary actions.
11. Red Line: There is no off side, red line rule.
12. Standard Rules: Unless specified in league by-laws, the standard rules of play as provided through Roller Hockey Canada apply.
13. Injury to Teeth: In the event of injury or damage to teeth, coverage is only provided to players wearing either an internal or external protective device or full face shield. At the time of injury, the player must report the circumstances, with confirmation of the protective device to the referee, who must file a formal report in order for coverage to be provided.
14. All other coverage is limited to the terms and conditions of the insurance policy and this document in no way shall supercede coverage provisions.
WAIVER TERMS & CONDITIONS
In consideration of the opportunity to participate in the league and further in consideration of the payment of my registration fee, which is hereby acknowledged, I, for myself, my heirs, executors, administrators and assigns, waive any and all claims, including claims for contribution of indemnity, to which I may become entitled as against the league, its executives, Board of Directors, committees, organizers, sponsors, and their agents and employees, and any other person or organization assisting in any losses
suffered by me or others as a result of my attendance at, participation in or traveling to or from any games or events. I hereby waive and all aforementioned claims, notwithstanding that any such injury damage or loss may have arisen by reason of the negligence of the league, its executives, Board of Directors, committees, organizers, sponsors, or their agents or employees. I confirm that I am in proper physical condition to participate in any and all games or events organized by or on behalf of the league and I am aware that participation could, in some circumstances, result in physical injury, property damage, or losses for which the league, its executives, Board of Directors, committees, organizers, sponsors and their agents and employees are hereby released. No oral representations, statements or inducements apart from the foregoing written agreement have been made and this certificate forms the entirety of the agreement.