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| Team:_________________ |
Name:_____________________ |
Phone:______________ |
For insurance purposes, items #1 and #2 must be
completed in full:
1. Date of Birth (MM-DD-YYYY): _________________
2. Medical Conditions?__________________________
General Release: In consideration of
being admitted to play in the WOMEN'S HOCKEY CLUB OF TORONTO 2010
Tournament, I hereby release and forever discharge the WOMEN'S
HOCKEY CLUB OF TORONTO, its players, organizers and managers from
any and all liabilities, actions, causes of actions, claims and
demands for damages, loss or personal injuries, howsoever arising
and including, but not limited to injuries arising from my
participation in said sports of the WOMEN'S HOCKEY CLUB OF TORONTO,
which heretofore may have been or may hereafter be sustained by me
in consequence of my participation in the 2010 Tournament of the WOMEN'S HOCKEY CLUB
OF TORONTO. I hereby acknowledge that there are no warranties
or conditions, express or implied that hockey games or practices sponsored
by the WOMEN'S HOCKEY CLUB OF TORONTO, shall be conducted so as to
prevent or minimize the risk of personal injury, and further acknowledge
that the WOMEN'S HOCKEY CLUB OF TORONTO makes no representation whatsoever
as to the competence or ability of its players to participate in league
activities in a safe manner. I further acknowledge that I am
aware of all the risks of personal injuries arising from my participation
in the WOMEN'S HOCKEY CLUB OF TORONTO 2010 Tournament. I acknowledge
having read the above and understand the nature and effect of this
release.
Dated at ___________________, this _______ day
of _______________, 2010.
________________________________
__________________________
Witness' Signature Applicant's
Signature
(adult over 18 years of age)
_______________________________
_____________________________
Witness (please print name clearly) Applicant
(please print name clearly)
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