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Program Waiver

Program Release and Waiver of Liability

  1. The participant assumes all risk of personal injury which may result from participation in the Canlan Ice Sports program. Be advised that all Canlan Ice Sports programs require full equipment. In all soccer programs proper fitting shin guards and full soccer socks to cover are mandatory
  2. The participant will not hold Canlan Ice Sports, any of the officials or staff liable for injury which the player may sustain while participating in the program. The participant understands and agrees that all sports and activities at camp have physical dangers which may result in serious injury or death. However, this clause applies only to the extent that such injury, death or loss is not caused by the negligence of Canlan or its employees.
  3. The participant is advised to carry additional medical insurance
  4. The participant certifies that he/she has no known medical condition which would prohibit him/her from participating in the program and the participant agrees that he/she will act in a responsible manner during all programs
  5. The participant agrees to reimburse Canlan Ice Sports, in full within 5 days of notice, for the cost of any property damage for which the player is held responsible by the Canlan Ice Sports Staff, Management or officials.
  6. Individuals who participate in the Canlan Ice Sports programs understand that Canlan Ice Sports and Canlan Ice Sports Corp. shall not be held responsible in any way for any accident or injury of medical expense incurred as a result of his/her participation in the program.
  7. Canlan Ice Sports is not responsible for any stolen, damaged or lost articles.
  8. I hereby grant and release to Canlan Ice Sports, the right to use photographs, audio tapes, and/or videotapes in which I and/or my children appear in any materials such as videos, films, recordings, still photographs or articles relating to Canlan Ice Sports, its programs and services including, but not limited to, brochures, newsletters, annual reports or our Web site, whether broadcast on television, radio or any other medium.
  9. Canlan collects and uses personal information in line with the 10 Privacy Principles. By providing us with your information, you consent to Canlan’s use of this information surrounding pertinent information for the product or service you are enrolled in. For more information, ask for a copy of our brochure: Protecting Personal Information & Privacy Makes Good Sense or visit our website at www.icesports.com

This is to certify that I, above named participant, or parent/guardian with legal responsibility for this participant, do consent and agree to the Program Release and Waiver of Liability 

Today's Date: January 15, 2019

First Participant's Name

First Name*

Last Name*
First Participant's Date of Birth*
First Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive future emails from Canlan Ice Sports Corp. regarding their products, services, sales and special events
Parent / Guardian Information

#1: Parent/ Guardian Full Name: *
Relationship:*

Phone 1: *

Phone 2: *

#2 (Optional) : Parent/ Guardian Full Name:
Please Select:

Phone 1:

Phone 2:
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Program Name: *

Session: *

Medical Information


My child has the following allergies, or pre-existing illness/health concern (s). Please indicate if an Epipen and/ or any other medications are carried by your child:
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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