Team Registration Form

Transcription

Team Registration Form
SPRING 2015 ARENA LEAGUE
_____________________________________LEAGUE INFORMATION___________________________
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League runs from April to June
Tournament held on July 10-12 weekend
Team fee $2,000 and Individual fee $150
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Registration closes March 30, 2015
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Players must be eighteen (18) years of age and up
Offering Weekday and Weekend divisions
Twenty-two (22) players max per team
Games played at local arenas
Awards and cash prizes
________________________TEAM REGISTRATION INFORMATION______________________
Team Name: ____________________________
Tier: WE or WD I __ II __ III __ IV __
Team Primary Colour: _____________________
Payment Option: Cash __ Cheque __
___________________________TEAM REP INFORMATION___________________________
Primary Rep
Secondary Rep
Name:
Name:
_______________________________
_______________________________
Address: _______________________________
Address: _______________________________
_______________________________
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Home Phone: ___________________________
Home Phone: ___________________________
Cell Phone: _____________________________
Cell Phone: _____________________________
E-mail: _________________________________
E-mail: _________________________________
Contact Information:
Sam Vigneswaran – [email protected]
Justin Beyerle – [email protected]; 519- 589-2536
See Back of Page
Mail Registration to: 369 Strawberry Cr., Waterloo, ON N2K 2J7
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Release of Liability, Waiver, and Authorization
I hereby acknowledge that in consideration of being able to participate in this WRABHL program, including but
not necessarily encompassing games, exhibitions, performances, development, practices, programs or activities,
operated and sanctioned by WRABHL and in consideration of the time, effort, and money expended by
WRABHL in organizing, operating, or sanctioning such programs or activities and for other good and valuable
consideration the receipt of which is hereby acknowledged:
1. I do hereby release WRABHL, its officers, directors, employees, contractors, servants, agents, volunteers,
and members from all claims, damages, causes of action or any recourse whatsoever in respect of all personal
injuries or damage to property which may occur while attending or participating in this WRABHL program and
do discharge those parties from any such liability.
2. I do hereby acknowledge and agree that the sport of ball hockey and its programs and activities are by their
nature risky and hazardous and I accept personal responsibility for those risks and hazards notwithstanding that
any personal injury or loss of property which may incur is due to the negligence of WRABHL or any of its
officers, directors, employees, contractors, servants, volunteers, and members.
3. I do hereby acknowledge and agree that notwithstanding the generality of the foregoing I declare that I will
not commence litigation or otherwise recover damages or other compensation for personal injury or loss of
property against WRABHL based on any claim, damages, causes of action or any recourse whatsoever arising
out of games, exhibitions, performances, programs, and activities organized, operated, or sanctioned by
WRABHL as a complete defence to any and all claims, damages, causes of action, or recourse or liability which
may arise at any time.
4. I do hereby grant permission for me to participate in all activities of this WRABHL program in consideration
of all listed herein.
5. In the interest of my health and safety, I hereby grant WRABHL permission to, in the event of an accident or
illness involving me, while participating in this program offered by WRABHL, I do hereby authorize
WRABHL, its officers, directors, employees, contractors, servants, agents, volunteers, and members to provide
the administration of any medical procedure and care they deem necessary. I also hereby agree to reimburse
WRABHL in full for all expenses incurred in providing me the medical procedure and care deemed necessary.
6. I do hereby authorize me to appear in any publicity arranged or sanctioned by WRABHL through various
media, including but not encompassing newspaper, radio, television, internet, newsletters, electronic
newsletters, slide presentation, and other publications.
I have carefully read this release of liability, waiver, and authorization which I fully understand and I am freely
and voluntarily signing it. I expressly acknowledge that I have the option of not participating in this program as
offered by WRABHL but do so upon the terms and conditions set out above.
Rep Name: ________________________
Rep Name: ________________________
Signature: _________________________
Signature: _________________________
Date: _____________________________
Date: _____________________________
Mail Registration to: 369 Strawberry Cr., Waterloo, ON N2K 2J7
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