Loading...

 

WAIVER AND RELEASE OF LIABILITY FORM FOR FIERCE HOCKEY INC

Assumption of risk release and waiver of liability indemnity agreement

To: All participants/parents/guardians (collectively the “Participant”)

In consideration of allowing my minor child/ward to participate in the program, related events and activities of Fierce Hockey and in the Fierce Hockey off-ice room at RINX.

I WARRANT TO YOU THAT:

1. I am a parent/guardian having full legal responsibility for decisions regarding my minor child/ward, and

2. I am familiar with the risk of severe injury and death which any participant in this program must assume, and

3. I believe that my minor child/ward is physically, emotionally, and mentally able to participate in this program, and that his/her equipment is mechanically fit for his/ her use in this program. In the case of my child/ward returning to play with a cast on child/ward arm that further injury to that arm or any other injury caused by restrictions of play due to arm injury will be excluded from insurance coverage.

4. I understand, and will instruct my minor child/ward, that all applicable rules for participation must always be followed and that the sole responsibility for personal safety remains with my minor child/ward, and

5. I will immediately remove my minor child/ward from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that my minor child/ward has experienced any deterioration in his/her physical, emotional or mental fitness for continued participation in the program.

I UNDERSTAND AND AGREE, ON BEHALF OF MY MINOR CHILD/WARD, MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN, THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES:

1. an unqualified ASSUMPTION OF ALL RISKS associated with participation in this program by my minor child/ward even if arising from negligence, or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of the program organizer and any persons associated therewith or participating therein, and

2. a FULL AND FINAL RELEASE AND WAIVER OF LIABILITY of the program organizer and all persons and organizations associated with it and the program including, without limiting the generality of the foregoing, its officers, directors, officials, agents and/or employees, other participants, volunteers, sponsors, advertisers, owners and/ or lessors of the premises used to conduct the program, sanctioning bodies, medical or rescue personnel (the RELEASEES), of and from with the respect to all injury, disability, death or loss or damage to person or property whether arising from the negligence, or negligent rescue of or by the foregoing or otherwise, and

3. an UNDERSTANDING NOT TO SUE the RELEASEES for any loss, injury, costs or damages of any form or type, how so ever caused or arising, and whether directly or indirectly from the participation of my minor child/ward in the program, and

4. an AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the RELEASEES or otherwise.

I acknowledge that Fierce Hockey Inc. and their directors, officers, coaches, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers.

Acceptance of Policies

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent provided by law.

Participants not adhering to the Fierce Hockey Inc guidelines and policies may be asked to leave the camp, class or lesson and is at the discretion of Fierce Hockey Staff.

I Agree

I HAVE READ, OR HAD EXPLAINED TO ME, THIS AGREEMENT AND I FULLY UNDERSTAND ITS TERMS, HAVE FULL AUTHORITY TO BIND MYSELF TO THIS AGREEMENT AND UNDERSTAND THAT BY DOING SO I ACCEPT THE RISKS AND RESPONSIBILITIES OUTLINED. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING THIS AGREEMENT AND I SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Date: All participating Fierce Hockey Classes, Camps, Programs, OFF-ICE room in 2024 and 2025.

First Parent or Guardian Name

First Name*

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

First Name*

Last Name*
Second Parent or Guardian Date of Birth*
Third Parent or Guardian Name

First Name*

Last Name*
Third Parent or Guardian Date of Birth*
Fourth Parent or Guardian Name

First Name*

Last Name*
Fourth Parent or Guardian Date of Birth*
Fifth Parent or Guardian Name

First Name*

Last Name*
Fifth Parent or Guardian Date of Birth*
Sixth Parent or Guardian Name

First Name*

Last Name*
Sixth Parent or Guardian Date of Birth*
Seventh Parent or Guardian Name

First Name*

Last Name*
Seventh Parent or Guardian Date of Birth*
Eighth Parent or Guardian Name

First Name*

Last Name*
Eighth Parent or Guardian Date of Birth*
Ninth Parent or Guardian Name

First Name*

Last Name*
Ninth Parent or Guardian Date of Birth*
Tenth Parent or Guardian Name

First Name*

Last Name*
Tenth Parent or Guardian 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*

Phone*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!