Camp 46

U7/U9/11 Power Skating and Skills Fall/Winter Program

at Terwillegar Arena 'D'

First Name *

Last Name *

Street Address *

City *

Postal Code *

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Phone Number *

Emergency Contact Name *

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Emergency Contact's Relationship with Participant *

Emergency Contact Phone Number *

Participant Birthday (Day) *

Participant Birthday (Month) *

Participant Birthday (Year) *

Gender *

2025 Category *

Level *

Jersey Size *

Jersey Number Preference *

Medical History

Please leave blank if there are no medical issues

Friend/Sibling Request *

First and last name(s)

Waiver

PAUL MANNING FUNDAMENTALS HOCKEY WAIVER, ASSUMPTION AND ACKNOWLEDGEMENT OF RISK FOR MINOR PARTICIPANTS (AGES 6 to 17)

MINOR ACKNOWLEDGEMENT AND ASSUMPTION OF RISK

I UNDERSTAND AND AGREE that there is potential risk for injury involved in the participation of any physical activity. I further understand and agree that participating in ice hockey is a potentially dangerous activity. Minor injuries or more serious injuries are possible, including sprains, strains, twists, cramps, fractured or broken bones, and torn ligaments, though most participants do not encounter serious injuries. There remains, despite safety precautions, the remote possibility of crippling or death. I FREELY ACCEPT AND FULLY ACKNOWLEDGE all such risks, dangers and hazards, resulting from my participation in hockey camp.

It is my right and responsibility as a participant to immediately remove myself from participation in the program and notify the nearest official, if at any time I sense any unusual hazard or unsafe condition or if I feel that I am physically, emotionally, or mentally unfit for continued participation in the program.

I have read and understand the above statement of risk. I assume responsibility for my own safety, and I understand and accept the risks involved with ice hockey.

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT FOR PARENTS OF MINOR PARTICIPANT

In consideration of approval for my minor child to participate in hockey camp, its affiliated provincial/territorial sport-governing bodies, and clubs, I hereby agree as follows:

TO WAIVE ANY AND ALL CLAIMS that I or my minor child have or may in future have against Paul Manning, its officials, members, agents, directors, officers, employees and representatives, and other participants (all of whom are hereinafter collectively referred to as “Releasees”).

I HAVE READ, understood and agree with the statements in the MINOR ACKNOWLEDGEMENT AND ASSUMPTION OF RISK portion of this document, and by assuming and acknowledging this risk, I completely absolve all RELEASEES from any and all liability for loss, damage, injury or expense that my minor child may suffer, that I may suffer, that a third party may suffer, or that my next of kin may suffer as a result of my minor child’s participation in any of the activities and/or programs offered by the Releasees, DUE TO ANY CAUSE WHATSOEVER. I acknowledge my responsibility to ensure adequate medical health of my child, as well as protection of my child’s personal possessions.

IN ENTERING INTO THIS AGREEMENT I am not relying upon any oral or written representations or statements made by the Releasees other than what is set forth in this agreement.

I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS OR ASSIGNS MAY HAVE AGAINST THE RELEASEE.

Signed on Date

Participant Signature *

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Parent of Participant Signature *

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Parent Full Name *

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Parent email address *

Witness Signature *

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Witness Full Name *

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