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Hockey Phd Participation waiver
First Name
Last Name
Email
Participant First Name
Participant Date of Birth
Participant Last Name
Please specify anything we should know about
I declare that the info I’ve provided is accurate & complete
I assume all responsibility for any and all risk of personal injury, property damage or death that may occur to the above-named camper as a participant in Hockey PHD’s any activities including but not limited to, practices, scrimmages, skills sessions, clinics, day camps, boarding camps, games. Additionally, the undersigned hereby agrees, on behalf of myself, my child(ren), my heirs and my personal representatives or their heirs or personal representatives, to fully and forever discharge and release Hockey PHD and its affiliates, and their respective owners, partners, agents, operators, managers, employees, and representatives (“Released Parties”) from any and all claims I or my child(ren) may have or hereinafter have for any illness, injury, temporary or permanent disability, death, damages, liabilities, expenses and or causes of action, now known or hereinafter known, in any jurisdiction in the world, attributable, or relating in any manner, to my child’s or children’s attendance and participation at the camp, whether caused by the negligence of Hockey PHD or any of the Released Parties or by any other reason. I acknowledge and agree that this Release and Waiver of Liability is intended to be, and is, a complete release of any responsibility of the Released Parties for any and all illness (including COVID19 or other communicable disease or illness), personal injuries, temporary or permanent disability, death and or property damage sustained by my child while attending and or participating in the camp. Further, all of the above-named camper’s physicals and inoculations are up-to-date. This document shall also serve as my authorization and permission to have my child attended to and or admitted to a healthcare facility for any necessary medical or dental treatment in the case of sickness or injury while attending camp. I hereby grant Hockey PHD the right to use photographs, video images and/or other media of my child for publicity, advertising and/or other commercial purposes. I understand the camp may be photographed, videotaped or otherwise recorded. I agree to let the above parties use my name, photo likeness and demographic information free of charge in any manner and for any purpose in any media now known or hereafter created. Hockey PHD has a zero tolerance policy with respect to uncontrollable behavior, bullying, hazing, alcohol, tobacco, drugs and other controlled substances and weapons of any kind. Any camper exhibiting or possessing any of these will be immediately dismissed from the camp and will forfeit all amounts paid. By signing below, and by being enrolled in this camp, I assent to the enforcement of this policy, and I hereby grant Hockey PHD the right to inspect any and all personal belongings of my child at any time on or off premises in relation to the camp. I understand that dates, times and locations of the camp are subject to change. I understand that this document is intended to be as broad and inclusive as permitted by the laws of the state in which the camp is taking place and agree that if any portion of this agreement is invalid, the remainder shall continue in full legal force and effect. I agree that this Acknowledgement, Waiver and Release will be governed by and interpreted in accordance with the laws of the USA without giving effect to the principles of conflicts of law.
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*Please be sure to fill out and submit the waiver form prior to the first day of camp
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