Parent Name *

Parent/Guardian must be over 18 years old.

First Name

Last Name

Player Name *

First Name

Last Name

Phone *

(###)

###

####

Supervisor/Coach *

I am 18+ years old and I agree to be a supervisor/coach on the ice. I understand that there may not be a parent on the ice for each skater and I agree to help monitor and notify rink staff if a player or parent is participating in an unsafe manner.

Yes

No

Age Group *

Mite/Squirt Session

Peewee/Bantam Session

Desired Date *

There will be a max of 30 skaters on the ice including parents. If we have reached our max additional participants will be put on a wait list and will be contacted if space opens.

May 21 Peewee/Bantam Only

May 28

June 18

June 25

SKATE AT YOUR OWN RISK AGREEMENT TO WAIVE VALUABLE LEGAL RIGHTS

In consideration of receiving permission from the Mid-Cape Ice Arena, Inc., hereinafter referred to as Tony Kent Arena, to ice skate or otherwise use the rink facilities, I hereby expressly agree: EXPRESS ASSUMPTION OF RISK/RESPONSIBILITY: To assume all risk and responsibility, for any injuries I may sustain, any injuries I may cause to any other person, and any damage I may cause to TONY KENT ARENA or to my property or to the property of any other person in connection with my activities at the TONY KENT ARENA, including without limitation, injuries or property damage caused by any equipment I may rent at the facility. COMPLETE RELEASE FROM LIABILITY: To release the TONY KENT ARENA and its directors, officers, instructors and employees, from ALL CLAIMS AND LIABILITY for any injuries I may sustain or any damage that may be caused to my property in connection with my activities at the TONY KENT ARENA, including without limitation, injuries or property damage caused by any equipment I may rent or bring into the facility, even if my injuries or the damage to my property is caused, in whole or part by negligence or fault of the TONY KENT ARENA, its directors, instructors or employees. MEDICAL TREATMENT LIABILITY RELEASE: To allow TONY KENT ARENA to provide emergency first aid care and arrange, if deemed necessary, for transport to a suitable medical care facility and that I will in no way hold TONY KENT ARENA, its directors, instructors or employees liable for administering such care. I have read and understand this agreement and enter into it freely and voluntarily. I certify that I am 18 years of age and have the legal capacity to enter into this AGREEMENT or that I am the parent or guardian, or coach of the skaters utilizing rink facilities.

I have read and understand this agreement and enter into it freely and voluntarily. I certify that I am 18 years of age and have the legal capacity to enter into this AGREEMENT or that I am the parent or guardian, or coach of the skaters utilizing rink facilities.