Summer Slam Registration

Information

Team Name:

*

Managers Name and Contact Information:

Name:

Email:

*

Telephone:

Cell:

( ) -

( ) -

Coaches Name and Contact Information:

Name:

Email:

*

Telephone:

Cell:

( ) -

( ) -

Registration Age Group:

*

Select Year:

None Selected 1995 1996 1997 1998 1999 2000

Extra Info

Waiver and release: I acknowledge that the sport of hockey has inherit risks of injury. In consideration of registering for a Tournament hosted by the Durham Hockey Institute, the undersigned hereby: 1. 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 2. 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

 

*  Asterisk items are required fields

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