Information Name: Street Address: City: State: Zip Code: Country: Email: Telephone: Date of Birth: Height: Weight: School Name of your school: School Area None Selected Delaware and Eastern PA Senior Prep Delaware and Eastern PA Senior Public New Jersey Senior Prep New Jersey Senior Public Select Area:                                    Left            Right          Left                   Right Goalie     Center     Wing          Wing          Defense           Defense Position Select all   that apply: Shoots  Left        Right Select one: Club Team Hockey High School Coaches Name and contact info Name: Cell Phone: Home Telephone: Club Hockey Team Coaches Name and contact info Name: Cell Phone: Home Telephone: Any Extra Detailed Information Extra Info:        Waiver and release:        I acknowledge that the sport of hockey has inherit risks of        injury.  In consideration of joining a game hosted by the        Durham Hockey Institute, the undersigned hereby: Releases and discharges Durham Hockey Institute, it’s directors, employees and agents (the “Releasees”) from any and all liability for any injury however occurring, whether from negligence on the part of the Releasees or otherwise: and I hereby agree to indemnify and  save harmless the Releasees from any and all causes of action brought against them as a result of any injury however occurring. Please select the box indicating if you have read, understood and accepted the Waiver and Release <<<  Please Check <<<    Waiver Box