1. Petrolia Ball Hockey League
2012 Registration Form
Cost To Play - $110
Personal Information:
First Name:
Last Name:
Phone:
City:
Address:
Experience: Please try to fill in this area accurately. The competitive balance of the league depends on it. Trades maybe required to replace improperly rated players and even out the teams in the league.
Rating
Plenty of experience
Can handle myself
I will volunteer to be a captain if required
3 It’s been a few years
Giving it a try
Highest Level of Hockey Played: When Played: _____________
Position:
Forward
Defense
Goal
No Preference
**Goaltenders require their own equipment**
If we’re short on Goaltenders, I will be willing to take my turn between the pipes
Special Requests:
We will try to satisfy requests of 1st year players during the draft, but we will not make any guarantees. If it is important for you to play with another person because of travel reasons, please list them below.
Medical:
To the best of my knowledge, I have no medical conditions which would make it dangerous for me to participate in this league
Signature:
Date:

2. Petrolia Ball Hockey League
Official Agreement, Waiver and Release
In consideration for being permitted to participate in the Petrolia Ball Hockey League, I hereby waive, release, and discharge any and all claims for damages for personal injury, death or property damage which I may have, or which may hereafter accrue to me, as a result of participation in said activity. This release is intended to discharge in advance the Petrolia Ball Hockey League (its officers and volunteers) from any and all liability arising out of or connected in any way with my participation in said activity, even though that liability may arise out of negligence or carelessness on the part of the persons or entities mentioned above. It is understood that this activity involves an element of risk and danger of accidents and knowing those risks I hereby assume those risks. It is further agreed that this waiver , release and assumption of risk is to be binding on my heirs and assigns. I agree to indemnify and to hold the above persons or entities free and harmless from any loss, liability, damage, cost, or expense which may incur as the result of my death or any injury or property damage that I may sustain while participating in said activity.
I am fully aware that the Petrolia Ball Hockey League carries no medical insurance for any participant and that I am solely responsible for securing my own insurance.
I am aware that there are rules and regulations governing the adult sports program. I know, and have read, these rules and understand them. In addition to the rules, there are also standards of behavior called “The Code of Conduct”: which I know, or have read. My signature on this agreement, waiver, and release indicates I agree to abide by the rules and code of conduct. I am aware that failure to abide by these rules and code of conduct may result in disciplinary action which could result in my suspension from this program, depending on the severity of my actions.
Participants must be eighteen (18) years or older to participate in this program.
I HAVE CAREFULLY READ THIS AGREEMENT, WAIVER, AND RELEASE AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN MYSELF AND THE PETROLIA BALL HOCKEY LEAGUE, AND I SIGN IT OF MY FREE WILL
Print Name:
Date:
Signature: