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Authorization, Waiver and

Release of Liability

Youth Pond Hockey Festival


I acknowledge that my son or daughter (“participant”) will participate in the Youth Pond Hockey Festival (the “Event”) and as a condition to their participation in the Event, I agree with the following:

  1. I hereby grant to the Youth Pond Hockey Festival (YPHF), Purity Spring Resort, King Pine Ski area, The Laura Foundation, The Host Counties (“County”), and The Host Towns (“Town”) their respective officers, directors, employees, affiliates, parents, subsidiaries, agencies, successors, assigns, and those acting with authority or permission from any of them (collectively, the “Released Parties”), THE ABSOLUTE IRREVOCABLE AND UNRESTRICTED WORLDWIDE RIGHT TO USE, PUBLISH, DISPLAY, EDIT, MODIFY, ALTER AND DISTRIBUTE IN PERPETUITY ANY AND ALL PHOTOGRAPHS, VIDEO OR OTHER LIKENESS OF THE “PARTICIPANT” PRODUCED IN CONNECTION WITH THE EVENT AND ANY ACTIVITIES RELATED TO THE EVENT as described herein (the “Materials”) bearing or containing, in whole or in part and combined with other materials, the participants name, voice, image, likeness, biographical information or any other identifiable representation or personal indicia of the participant (collectively, “Likeness”). The Materials may appear in any form, style, color or medium whatsoever now existing or developed in the future (including, without limitation, photographs, videotapes, films, sound recordings, software, drawings, print publications, broadcast, Internet and electronic media) and may be used for any purpose (including, but not limited to, illustration, promotion, art, advertising, trade, or any other purpose whatsoever). I ACKNOWLEDGE THAT NO FEE WILL BE PAID TO ME OR THE “PARTICIPANT” IN CONNECTION WITH THE EVENT FOR USE OF THE MATERIALS AND/OR THE PARTICIPANTS LIKENESS AS PROVIDED HEREIN. I ALSO WAIVE THE RIGHT TO INSPECT OR APPROVE THE FINISHED MATERIALS OR ANY PART OR ELEMENT THEREOF THAT INCORPORATES, IN WHOLE OR IN PART, THE PARTICIPANTS LIKENESS. I AGREE THAT ALL MATERIALS CONTAINING MY LIKENESS OR THE PARTICIPANTS LIKENESS SHALL BE AND SHALL REMAIN THE SOLE AND EXCLUSIVE PROPERTY OF “YPHF” AND I HEREBY ASSIGN ANY PROPRIETARY RIGHT I MAY HAVE ACQUIRED IN OR TO SUCH MATERIALS TO THE PHC.
  2. I acknowledge, understand and agree that my participation and the “participants” participation in the Event is voluntary. I acknowledge that there may be potential for risk of injury from travel to, travel from and participation in the Event and I hereby knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for any and all injuries (including death) or loss arising from the “participants” participation in the Event.
  3. I, ON BEHALF OF MYSELF AND MY SUCCESSORS, HEIRS AND ASSIGNS, AGREE TO FOREVER WAIVE, RELEASE, DISCHARGE AND HOLD HARMLESS THE RELEASED PARTIES FROM AND AGAINST ANY AND ALL LIABILITY OR DAMAGES RELATING TO THE USE OF MY LIKENESS, INJURIES (INCLUDING DEATH) OR LOSS (INCLUDING DAMAGE TO PROPERTY) SUFFERED BY ME ARISING OUT OF OR RELATED TO MY TRAVEL TO, TRAVEL FROM AND PARTICIPATION IN THE EVENT OR ANY ACTIVITIES RELATED THERETO, REGARDLESS OF WHETHER SUCH CLAIMS RESULT FROM NEGLIGENCE OF ANY OF THE RELEASED PARTIES.
  4. If any provision of this Authorization, Waiver and Release is deemed to be invalid or unenforceable to any extent, the remainder of this Authorization, Waiver and Release shall not be affected, and each remaining provision of this Authorization, Waiver and Release shall be valid and enforceable to the fullest extent permitted by law.
  5. This Authorization, Waiver and Release shall be governed by and construed in accordance with the laws of the State of New Hampshire. Any suit or action arising shall be filed in a court of competent jurisdiction within the State of New Hampshire. I hereby consent to the personal jurisdiction of said court within the State of New Hampshire, and waive all defenses of lack of personal jurisdiction and forum non conveniens.
  6. I hereby warrant and certify that I am at least 18 years of age and have the right to contract in my own name and in the name of the “participant”.
  7. By electronically submitting this form, I acknowledge that I understand and accept that there are risks for the “participant” involved in participating in any recreational activity, are aware of those risks, and are voluntarily allowing the “participant” to participate in this activity with knowledge of the risks involved. I on behalf of the participant agree to accept any and all such risks of injury, death and/or property damage. In consideration for being allowed to participate in this recreational activity, I will agree to the terms of this waiver, release, covenant not to sue and indemnity agreement as set forth herein. I, on behalf of myself, the ”participant”, my heirs, next of kin, assigns and personal representative will waive, release, absolve, indemnify and agree to hold harmless the Youth Pond Hockey Festival, all YPHF Sponsors, Purity Spring Resort, King Pine ski area, the Host Towns and all members, officers, directors, employees, volunteers, agents or any other representative of YPHF, YPHF Sponsors, Purity Spring Resort, King Pins Ski Area, the Host Towns against any and all causes of action, claims, demands, losses, expenses, liability.
  8. I ACKNOWLEDGE THAT I HAVE CAREFULLY READ AND UNDERSTAND THIS AUTHORIZATION, WAIVER AND RELEASE, AM FULLY FAMILIAR WITH AND UNDERSTAND ITS TERMS, HAVE HAD ANY QUESTIONS REGARDING ITS EFFECT OR THE MEANING OF ITS TERMS ANSWERED TO MY SATISFACTION, ALL PRIOR TO ITS EXECUTION, AND AGREE TO THOSE TERMS FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT OR COMPULSION AND I UNDERSTAND I AM GIVING UP VALUABLE LEGAL RIGHTS IN SIGNING THIS AGREEMENT. This Authorization, Waiver and Release shall be binding upon me, the “participant, and my heirs, legal representatives and assigns.





What is the name of your organization?
Organization *
First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
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.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also 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 Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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