2017-2018 Major Midget Player Information Form (Lambton Jr. Sting AAA Hockey )

Print 2017-2018 Major Midget Player Information Form
Lambton Zone Players Only
  1. example: Jan 1, 2001
  2. (taxes paid to)
  3. Example: XXX-XXX-XXXX
  4. RadDatePicker
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  5. Example: ###-###-####
  6. Example: XXX-XXX-XXXX
  7. Example: XXX-XXX-XXXX
ACCEPTANCE OF RISK/WAIVER OF RESPONSIBILITY
I am aware and approve of the above-named player's registration to participate in tryouts for the Lambton AAA Hockey Association. I undertake that the above-named player is in good health except as noted above. I relinquish to the player's coach/instructor the right to instruct, direct and as appropriate, discipline the player during the specific team tryouts the player is participating in. The undersigned Parent/Guardian hereby releases, remises and forever discharges the Lambton AAA Hockey Association and their heirs, executive, coaches, trainers, managers, committees and instructors of all action, causes of actions, damage claims and demands whatsoever which may arise from any incident to the praticipating child and/or player and /or property while practicing, playing, travelling to or from hockey related events arranged by, through or supervised by though or supervised by said association. The undersigned Parent/Guardian acknowledges having read and understood the information on the back of this form regarding OHF regulations E28-E42.
  1. Check one option only
  2. (please print name)
  3. (month/day/year)
OPT-OUT PROVISION (PRIVACY ACT)
I acknowledge and understand that, for the purposes of offering additional products and services that may be of interest to the participant or the participant's family, Hockey Canada and/or the Lambton AAA Hockey Association may use or disclose the participant's name and address collected on this form to third parties. As the above-mentioned participant, or the participant's legal guardian, if you do NOT wish that information used or disclosed for the purpose of offering you such additional products and services, please indicate below.
  1. Example: [email protected] Your submission will be sent to this address.
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Printed from lambtonjrsting.ca on Monday, April 23, 2018 at 10:46 PM