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2024 Registration Form
PLAYER DETAILS
First name
Last name
Is player a minor?
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Parent First Name
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Insurance Policy Holder Name
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Insurance Group Number
Hospital of Choice
EMERGENCY CONTACT DETAILS
Contact First Name
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Contact Phone Number
Parent/Guardian Agreement: I have read this fact sheet on concussions and talked with my Player about what to do if they have a concussion or serious brain injury.
USA Hockey Concussion Management
Athlete Agreement: I have learned about concussions and understand what to do if I have a concussion or serious brain injury.
USA Hockey Concussion Management
Release of Liability
By completing this registration process, I acknowledge that participation in ice hockey training is not without risk. I am participating in this program voluntarily. I have read and accept the full Release of Liability.
By completing this registration process, I acknowledge that participation in ice hockey training is not without risk. The Player is participating voluntarily with my consent and approval. I have read and accept the full Release of Liabilty.
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