Please only fill out ONE form per family. (If you have two or more kids/players participating at this event, you only need to fill out this form once)

Player Information

Player First Name*

Player Last Name*

Player Birthdate*

Year-Month-Day

Player Gender*

AAA Showdown - 2023 - Team*

Second Player Information

Second Player First Name

Second Player Last Name

Second Player Birthdate

Year-Month-Day

Second Player Gender

AAA Showdown - 2023 - Team (2)

Third Player Information

Third Player First Name

Third Player Last Name

Third Player Birthdate

Year-Month-Day

Third Player Gender

AAA Showdown - 2023 - Team (3)

Fourth Player Information

Fourth Player First Name

Fourth Player Last Name

Fourth Player Birthdate

Year-Month-Day

Fourth Player Gender

AAA Showdown - 2023 - Team (4)

Parent/Guardian Information

First Name*

Last Name*

Email*

Street Address*

City*

State/Province*

ZIP/Postal Code*

Phone Number*

Parent/Guardian Date of Birth*

Month/Day/Year

Additional Parent/Guardian Information

Additional Parent/Guardian First Name (if applicable)

Additional Parent/Guardian Last Name (if applicable)

Additional Parent/Gaurdian Date of Birth (if applicable)

Month/Day/Year

Additional Parent/Guardian Email (if applicable)

Acknowledging that I/(my child and or team) is registering for a contact sport, I agree that Play Hockey USA Inc. and Play Hockey Canada (Play Hockey), its agents, servants and employees shall not be liable to me/(my child and or team) for any injury or damage however caused, resulting directly from my/(my child's and or team's) participation in any Play Hockey USA Inc. and Play Hockey Canada events, whether incurred during the sporting event or otherwise in or about the buildings at any time preceding, during or subsequent to the delivery of the sporting program and I hereby discharge Play Hockey, its agents, servants, and employees from all actions, claims and demands I/(my child and or team) may have for any such injury and damage. I further agree to authorize Medical Proxy to Play Hockey its agents, servants and employees to secure emergency treatment in the event that I/(my child and or team) is injured and family/emergency contacts are not available. I also acknowledge that Play Hockey, its agents, servants, and employees are not liable to me/(my child and or team) for any injury and damage, howsoever caused, incurred at any time during the term Play Hockey program and I hereby discharge the Play Hockey, its agents, servants and employees from all actions, claims and demands for any such injury and damage. I understand and accept that there are risks involved in participating in any recreational activity, including, but not limited to, the potential for transmission of COVID-19. I am aware of those risks, and I am voluntarily participating in this activity with knowledge of the risks involved. I agree to accept any and all such risks of injury, and I am aware of the possibility of concussions, illness, death and/or property damage. I agree to the terms of this waiver, release, covenant not to sue and indemnity agreement as set forth herein. In case of injury or illness, I give my consent to emergency transportation and the administration of first aid, medical and/or dental treatment. I accept responsibility for the payment of any emergency transportation, treatment expenses and any related or subsequent medical and/or dental bills. I also understand and agree to the Play Hockey cancellation policy so that only a portion of my/(my child's and or team's) registration fee will be refunded to me (my child and or team) in the event, for whatsoever reason, I/(my child and or team) withdraws from any Play Hockey event. As well, I acknowledge and agree that no portion of my/(my child's and or team's) registration fee will be refunded to me/(my child and or team) in the event of cancellation of the program for reasons beyond Play Hockey‘s control, including damage to event buildings/fields, mechanical breakdown, pandemics, acts of god or other failure of the facilities which would, in Play Hockey.'s sole and unfettered discretion, prevent the proper operation of the sport program. I further acknowledge and agree that the Play Hockey does not insure and will not be expected, at any time, to insure the safety or the proper state of repair of my/(my child's and or team's) equipment used by me/(my child and or team) during the sporting program and that Play Hockey do not and shall not be considered to guarantee or warrant any instructional materials used by it during the sporting program.

I agree*

I also acknowledge and agree that the Play Hockey reserves the sole and exclusive right to take photographs and video recordings during any event. I hereby consent to the taking of photographs and video recordings of me/my child, in any format and any medium now known or hereafter developed, and irrevocably grant Play Hockey the perpetual right and license to take, edit, use, display, publish, distribute, reproduce, broadcast, or to make compilations of the photographs and/or video images taken of me/my child for the purposes of publication, promotion, advertising, trade and/or instructional purposes concerning Play Hockey or any of its related or affiliated companies and their undertakings. I acknowledge on behalf of me/my child that these rights are granted without cost or charge to Play Hockey and that no consideration or payment will be paid or payable by Play Hockey to me/my child on account of the use of those photographs and/or video recordings. I also understand and agree that my agreements, releases and discharges herein shall bind my heirs, legal representatives and assigns and shall inure to the benefit of the Play Hockey, its agents, servants and employees and their successors and assigns. By clicking agree below, I have read (including concussion link), understand and agree to all the terms of this photograph and video recording release.

I agree*

Parent/Guardian Signature*