LI STIX WINTER ADULT LEAGUE 2024-2025 Member Signup/Waiver
4 Dates: 12/19 Thursday 12/26 Thursday.  1/2 Thursday. 1/9 Thursday .
 8:00pm or 9:00pm Games
$165 
$155 active college
 venmo business profile @listixfh or paypal listixfh@gmail.com.
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First Name *
Last Name *
Phone Number *
Email *please double check correct most communication through this email *
Birthday *
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DD
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YYYY
Home address ( include town, zip code) *
Highest level of play *
If you played/play in College... where?
Position (check all that apply) *
Required
Team Selection. will try to accommodate all requests as best as we can. Goal is to make all the teams  as competitive as possible *
List any friends you want to play with (not guaranteed but will try to accommodate as best as possible)
Emergency Contact Name *
Emergency Contact Number *
I, for myself or as the parent or legal guardian of the above named registrant recognize the possibility of serious physical injury or death associated with physical activities including field hockey. I, from this day forward hereby forever release, discharge, hold harmless, and indemnify LI STIX FIELD HOCKEY LLC, it’s employees, representatives, agents, and associated personnel against any and all claims, causes of actions, and/or liability by or on behalf of the registrant as a result of the registrants’ participation in LI STIX FIELD HOCKEY LLC practices, camps, special events, league, tournaments, and out of state events/showcases. I hereby consent and agree that LI STIX FIELD HOCKEY LLC has the right to take photographs and/or videos of the above named registrant for feedback, social media (facebook, instagram, LI STIX FIELD HOCKEY LLC website), advertising, and marketing. I agree that LI STIX FIELD HOCKEY LLC reserves the right to cancel the registrant’s participation in any specific event or events and/or cancel membership in total if such registrant’s conduct and behavior includes but is not limited too; use of non-prescriptive drugs, vape pens, alcohol, foul language, aggressive/inappropriate behavior (on or off the field), posting on social media the wearing of LI STIX FIELD HOCKEY LLC’s apparel without the written permission of LI STIX FIELD HOCKEY LLC, and/ or any other action determined by LI STIX FIELD HOCKEY LLC to be detrimental to LI STIX FIELD HOCKEY LLC and it’s programs.                                                       ******PLEASE  SIGN. PARENT/GUARDIAN NAME MUST SIGN IF UNDER 18******** *
I, for myself or as the parent or legal guardian of the above named registrant am personally responsible for the safety and actions while attending LI STIX FIELD HOCKEY LLC. I agree to comply with all Long Island Field Hockey policies and rules, including but not limited to all LI STIX FIELD HOCKEY LLC policies, guidelines, signage, and instructions. Because the facilities that LI STIX FIELD HOCKEY LLC rents are open to other individuals/programs, I recognize that I am at higher risk of contracting COVID-19. I hereby from this day forward forever release, waive, discharge, hold harmless, and indemnify LI STIX FIELD HOCKEY LLC it’s employees, representatives, agents, and associated personnel against any and all claims, causes of actions, and/or liability by or on behalf of the registrant as a result of the registrants’ participation in LI STIX FIELD HOCKEY LLC practices, camps, special events, tournaments, and out of state events/showcases and use of equipment, materials, tools, facilities whether caused by the negligence of the Released Parties or otherwise specifically related to COVID-19.  I understand that if I think I or someone in my household have been in direct contact with someone who has COVID-19 I will not return to LI STIX FIELD HOCKEY LLC until I have quarantined for whatever the CDC requires.   I will maintain a social distance from other players and coaches from the moment I come to the field until I am picked up. I will treat everyone including staff as if they could be infected.                      ******PLEASE  SIGN. PARENT/GUARDIAN NAME MUST SIGN IF UNDER 18******** *
Upon submitting this form I will immediately sent payment to one of the following: *
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