RAA Sled Hockey Try It Clinic 2023-24 Registration
Thank you for registering for an upcoming RAA program! We are excited to see you soon!
Please complete the following information prior to your arrival to save you time at the event.

See you soon!

NOTE: A completed Registration Form is required for each participant. Once you complete one, you can return and complete the form for any additional participants. If you are completing this for another person as a parent or guardian, please complete the information as the participant. Thank you!


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Email *
First and Last Name *
Which program are you registering for? (Please check all that you will be attending.) We ask that you arrive on time to get the full benefit of the ice time. It takes a bit to get you checked in and fitted for equipment. *
Required
Best phone number to reach you for program changes and updates *
Are you completing this for yourself or for another individual? *
If you are answering for someone else, please answer questions as pertaining to them.
Mailing Address, State, Zip Code *
What is your gender *
Which categories best describe you? (You may choose more than one) *
Required
What is the YEAR of your birth? *
Please provide an Emergency Contact FIRST AND LAST NAME *
Emergency Contact Relationship to You *
Emergency Contact BEST Phone Number *
Understanding who we are impacting is important to our outreach, service provision and funding.    Do you have a disability or medical condition that impacts you? *
If you answered YES to the question above, please indicate the NAME OF YOUR DISABILITY OR MEDICAL CONDITION
If YES, What is the YEAR OF ONSET for your disability or medical condition? If NO, type N/A
Are you currently or have you ever been a member of the Military? *
How important is it to you that recreation is available to you and your family/friends so that you can participate together? *
Not very important to me
Very important to me
Take a moment and share places of recreation (municipalities, businesses, etc) that you would like to  see become trained in both physical and social inclusion operations: *
I agree that I will adhere to any safety protocols in place including Covid-19 measures as well as equipment and dock/path/gym/facility safety requirements. *
Photo/Video Release: Rochester Accessible Adventures has permission to photograph and videotape me during sessions for possible promotional or informational pieces about our work towards creating access and inclusion. Please know that this event may be filmed/photographed & by participating you agree to be recorded… but accommodations may be made at the event by talking with RAA Staff: Director, Anita O'Brien or Inclusion Specialist, Dee Mascari. *

Rochester Accessible Adventures Waiver & Release of Liability, and Media Release Agreement

Rochester Accessible Adventures (“Released Party”) is a non-commercial, not for profit activity provider and consultant.  The purpose of this agreement is to exempt, waive and relieve the Released party from any and all liability for wrongful death, personal injury, and property damage, including, but not limited to, liability arising from the negligence of Released parties.  “Released Parties” include Rochester Accessible Adventures, and their representatives, administrators, directors, agents, coaches, employees, and volunteers; other participates, sponsoring agencies, sponsors, and advertisers; and, if applicable, the owners, operators, and lessors of premises on which the activities or events take place.

In consideration of the undersigned Participant being allowed to participate in any way in Rochester Accessible Adventures related events and activities, the undersigned (“Undersigned” means the Participant or the Participant’s parent, legal guardian, or legal representative when the Participate in under the age of 18 or legally incapacitated) agrees and acknowledges as follows:

1.  Risks of Activity:  Participant will be taking part in activities that can be hazardous and involve the risk of physical injury and/or death.  The activities are inherently dangerous and Undersigned fully realizes the dangers of participation in the activities.  The dangers and risks of the activities include, but are not limited to the condition of the premises and equipment, and the acts, omissions, representations, carelessness, and negligence of the Released Parties.  Recognizing the risk and dangers, the Undersigned voluntarily chooses for Participant to participate in the activities and expressly assumes all risks and dangers of the participation in the activity, whether or not described above, known or unknown, inherent, or otherwise.

2. Release and Indemnification:  Undersigned (a) unconditionally releases, forever discharges, and agrees not to sue the Released Parties for any claims or causes of action for any liability or loss of any nature, including personal injury, death, and property damage, arising out of or relating to Participant’s participation in the activities , including personal injury, death, and property damage, arising out of or relating to Participant’s participation in the activities, including but not limited to claims of negligence, breach of warranty, and/or breach of contract the Undersigned may or will have against the Released Parties; and (b) agrees to indemnify, defend, and hold harmless the Released Parties from and against any liability or damage of any kind and from any suits, claims or demands, including legal fees and expenses whether or not in litigation, arising out of, or related to, Participant’s’ participation in the activity.

3. Helmet Use: Undersigned agrees that Participant shall use a helmet when participating in the following activities:  alpine skiing, cycling, equestrian, ice hockey, outdoor rock climbing, snowboarding, white water kayaking, white water river rafting, and any other activity when directed by Released parties.  Undersigned understands that a helmet is in no way a guarantee of safety and that no helmet can protect the wearer against all foreseeable impacts to the head, and that the activities can expose the Participant to forces that exceed the limits of protection provided by a helmet.  Undersigned agrees to assume full responsibility for complying with this paragraph and that Released Parties shall not be liable for any injury or damages resulting from Participant’s failure to use a helmet.

4. Miscellaneous:  Undersigned agrees (a) Participant will not engage in any activities prohibited by an applicable laws, statues, regulations and ordinances; (b) this agreement shall be governed by the laws of the State of New York and the exclusive jurisdiction and venue for any claim shall be located in the state courts located in Monroe County, New York; and (c) this agreement shall be binding upon the subrogor's, distributors, heirs, next of kin, executors, and personal representatives of the Undersigned.


I have read and agree with the RAA liability waiver. I understand that I need this signed document in order to participate.
If you are a legal guardian completing this form for someone else, what is your name, relationship, phone and email?
RAA uses email to send out updates on our work to bring inclusion in recreation across our communities. Please select the following to ensure you get these updates:
Please provide us with any additional information you would like us to know as part of your participation in the event. We strive to make your experience an outstanding one -- please let us know how we can help facilitate that for you!
A copy of your responses will be emailed to the address you provided.
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