ROCKVILLE ICE ARENA HIGH SCHOOL HOCKEY LEAGUE REGISTRATION Team Name: E-mail: First Name: Last Name: Date of Birth: Address: City: State: Zip: Telephone (H) : - - Telephone (C) : - - Therefore, I indemnify, and hold harmless Rockville Ice Arena, Montgomery Ice Arena Management Company, LLC, Montgomery Youth Hockey Association, Inc., and its and their respective directors, officers, agents, employees, volunteers and affiliates (collectively "Indemnitees") from any and all costs, losses, liabilities, damages, lawsuits, deficiencies, claims, expenses (including costs and attorney's fees) arising from bodily injury, personal injury, including death at any time resulting therefrom, sustained by me and or any person or persons or on account of damage to property, including loss of use thereof, arising out of or in consequence of: (i) my or my Guests' use or occupation of the facility including but not limited to any surrounding areas (including injuries to third parties and damage to property). (ii) any act or omission of me or my guests (iii) for any negligent acts and omissions in the operation, supervision or maintenance of the facility and the organization and conduct of hockey practices, scrimmages, clinics, tournaments and games. There will be a $25.00 service charge for non-negotiable payments. There will be no refunds once your application is processed unless teams do not make team limits. I have read the waiver/ agreement and the league rules. To the best of the knowledge, information, and belief of the individual signing this registration form, these statements as well as the matters and facts set forth in this registration form are true in all material respects, and this statement is made under the penalties for perjury. ____________________________ ____________________________ Print Player/Parent Name (if under age 18) Player/Parent Signature (if under age 18)
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