Program Registration

  • Player Information

  • Date Format: MM slash DD slash YYYY
  • Last Level Of Hockey Played

  • Program Selection

  • Liability Waiver

  • BREAKOUT HOCKEY SCHOOL – WAIVER AND RELEASE OF LIABILITY

    By signing this form, you give up important legal rights. Please read carefully.

    This is a binding legal agreement. As a Participant in the programs, activities and events of Breakout Hockey School, the undersigned acknowledges and agrees to the following items.

    Disclaimer
    Breakout Hockey School, its directors, officers, members, employees, coaches, volunteers, officials, participants, clubs, agents, sponsors, owners/operators of the facility, and representatives (the “Organization”) are not responsible for any injury, damage or loss of any kind suffered by a Participant during, or as a result of any program, tournament, game, hockey school, practice, activity or event, caused in any manner whatsoever including, but not limited to, the negligence of the Organization and its participants.

    Description of Risks
    In consideration of my participation in such programs, activities and events, I hereby acknowledge that I am aware of the risks and hazards associated with or related to ice hockey. The risks and hazards of ice hockey include, but are not limited to, injuries from:
    Exerting and stretching various muscles groups
    Vigorous physical exertion, rapid movements and quick turns and stops on the ice
    Strenuous cardiovascular workouts
    Collisions with the hockey boards, goalie nets and ice
    Being stuck by hockey sticks and pucks
    Physical contact with other with other participants, resulting in injuries to the eyes, teeth, face, head and other parts of the body, bruises, sprains, cuts, scrapes, breaks, dislocations and spinal cord injuries which may render me permanently paralyzed
    Variations in ice surface
    Travel to and from competitive events and associated non-competitive evens which are an integral part of the Organization’s activities.
    Furthermore, I am aware that:
    Injuries sustained in ice hockey can be severe
    may experience anxiety while challenging myself during the activities
    can lessen the chance of severe injury by wearing certified protective hockey specific equipment, including but not limited to, shin pads, elbow pads, shoulder pads, helmet, hockey gloves, hockey pants, athletic support and neck guard
    Despite the rules in place, violations and or accidents will occur and may result in injury
    My risk of injury increases as I become fatigued.

    Face Shields
    I understand that it is optional to wear protective face shields during games and training. I understand that if I choose not to wear a protective face shield while playing ice hockey, I am exposed to a much greater risk of injury. I acknowledge that in making the choice to wear or not wear a protective face shield that I have read and understand the conditions as described in the disclaimer herein.

    Release of Liability
    In consideration of the Organization allowing me to participate, I agree:
    To assume all risks arising out of, associated with or related to my participation.
    To be solely responsible for any injury, loss of damage that I might sustain while participating.
    To release the Organization from liability for any and all claims, demands, actions and costs including, but not limited to, breach of contract, breach of statutory duty of care or breach of the occupiers’ liability act, that might arise out of my participating, even though such risks, injuries, loss, damage, claims, demands, actions or costs may have been caused by the negligence of the Organization.

    Acknowledgement
    You expressly acknowledge that you have read this agreement and understand the rights, obligations, terms and conditions set forth herein. By signing this document, you acknowledge that you, the registered participant, expressly consent to be bound by its terms and conditions and grant to Breakout Hockey School the rights set forth herein. You acknowledge that you are of the legal age of majority, have read and understand this agreement and you are aware that by sighing this agreement, you are waiving certain legal rights. You have executed this agreement voluntarily, and that this agreement is to be binding upon yourself, your heirs, executors, administrators and representatives.

  • $ 0.00 CAD
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