Rogers Kids Club Application
Age:
Participant Name: Guardian Name (Must be 18+):
Address: City:
Postal Code:
Email:
Phone: (
Exp.
Credit Card No. T-Shirt Size (Circle One) Youth: S
)
M
L
XL
Adult:
S
M
Does the participant have any allergies: (Circle one) Yes If yes, please specify:
L No
*I __________________________(participant’s parent or legal guardian) hereby consent to the use of the participant’s information in publicity and advertising regarding future Peterborough Petes events without personal compensation. In addition, I (the participant’s parent or legal guardian) completely release and hold harmless the Peterborough Petes Hockey Club and any of its employees, volunteers, partners, sponsors or ‘Event Sponsors’ from any damages, injuries, or theft that arise before, during or after Roger’s Kids Club events. I am aware of, and accept these risks and will ensure that the participants are physically and mentally prepared in participating in the Roger’s Kids Club.
I HAVE READ AND UNDERSTAND THE TERMS OF THE ABOVE WAIVER, WILL COMPLY WITH THE TERMS AND ACKNOWLEDGE (WITH SIGNING THIS WAIVER) THAT I WILL BE GIVING UP LEGAL RIGHTS. GUARDIAN SIGNATURE__________________________________ DATE _________________
Participant Name: Guardian Name (Must be 18+):
Address: City:
Postal Code:
Email:
Phone: (
Exp.
Credit Card No. T-Shirt Size (Circle One) Youth: S
)
M
L
XL
Adult:
S
M
Does the participant have any allergies: (Circle one) Yes If yes, please specify:
L No
*I __________________________(participant’s parent or legal guardian) hereby consent to the use of the participant’s information in publicity and advertising regarding future Peterborough Petes events without personal compensation. In addition, I (the participant’s parent or legal guardian) completely release and hold harmless the Peterborough Petes Hockey Club and any of its employees, volunteers, partners, sponsors or ‘Event Sponsors’ from any damages, injuries, or theft that arise before, during or after Roger’s Kids Club events. I am aware of, and accept these risks and will ensure that the participants are physically and mentally prepared in participating in the Roger’s Kids Club.
I HAVE READ AND UNDERSTAND THE TERMS OF THE ABOVE WAIVER, WILL COMPLY WITH THE TERMS AND ACKNOWLEDGE (WITH SIGNING THIS WAIVER) THAT I WILL BE GIVING UP LEGAL RIGHTS. GUARDIAN SIGNATURE__________________________________ DATE _________________
