The Premiere Adult Invitational Ice Hockey Tournament

Player Information and Waiver Form

Player Information & Waiver Form

Page 1 of 2

Player Information & Waiver Form
  1. required Denotes Required Field
  2. Player Name:required
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  3. Team Name:required
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  4. Player's Age:required
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  5. Year of Birthrequired
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  6. Street Address:required
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  7. City:required
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  8. State:required
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  9. Zip Coderequired
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  10. Jersey Number:required
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  11. Your Email:required
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  12. Team Captain Emailrequired
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  13.  
  1. AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY

    In consideration of being allowed to participate in any way in the Independence Cup Classic Hockey Tournament, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

    1. The risk of injury from the activities involved in this program is significant, including the potential from permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

    2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,

    3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,

    4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Shinny USA, Inc., its officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertiser, and if applicable, owners and lessor of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, to the fullest extent permitted by laws, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

    5. I agree and consent that Shinny USA, Inc., reserves the right to use any pictures or videos taken during the Tournament for advertising and promotional purposes.

    I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

  2. Emergency Phone Number:required
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  3. Signaturerequired
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    You MUST type in your full name
  4. Today's Date:required
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  5. I Agreerequired

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    Check this box to Agree to the conditions above.
  6. required denotes required field