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Make sure you have filled out all of the fields on this form. Only the Alternate Phone field is not required. Once all fields are filled out, click the "Click Here to Send" button below.
I acknowledge and understand that
each player is voluntarily participating in activities that involve
risk of injury which might result not only from their actions,
inactions, or negligence, but the actions, inactions or negligence
of others, the rules of play, the conditions of the premises, or any
of the equipment used. This includes any risks not reasonably
foreseeable to Impact Hockey, the Minnetonka Youth Hockey
Association or Pagel Activity Center.
I assume the foregoing risks as a condition of participation and
accept personal responsibility for the damages following any
such injury.
I unconditionally release, waive, and consent not to sue Impact
Hockey, the Minnetonka Youth Hockey Association, or Pagel
Activity Center or its employees for any and all liability to the
undersigned.
I hereby give permission of images of my child, captured during
regular and special Impact activities through video, photo and
digital camera to be used solely for the purposes of Impact
Hockey promotional material and publications, and waive any
rights of compensation or ownership thereto.
Check this checkbox to acknowledge that you understand and agree to the above conditions.
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