Teen Hockey Night

Ages 13+

Play floor hockey in the gym, and share in a short devotion. Dress for the weather!

6pm-8pm Friday Night

December 13, 2024
February 7, 2025
April 11, 2025

Hockey Night Liability Waiver

Participant Birth of

Acknowledgment of Risks

I, the undersigned, acknowledge that participation in hockey night involves inherent risks, including but not limited to injury, physical harm, or even death. I understand that these risks may arise from my child(ren)’s actions, the actions of others, and the conditions of the facility. I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releasees or others, and assume full responsibility for my participation; and,

Release of Liability

In consideration of my child(ren) being permitted to participate in Hockey Night, I, for myself and on behalf of my child(ren), assigns, personal representatives and next of kin, hereby release and hold harmless Bliss Summit Bible Camp, their officers, officials, agents, employees, and/or other participants, (“releasees”), with respect to any and all injury, illness, disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise; and,

Permission to Participate

I hereby give permission for my child(ren) to participate in Hockey Night, recognizing the risks involved and accepting the terms of this waiver.

Duration

This waiver is valid from the date of signature until September 1^st, 2025.

Participant 1 Name *

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Participant 1 Date of Birth *

Participant 2 Name

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Last

Participant 2 Date of Birth

Participant 3 Name

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Last

Participant 3 Date of Birth

Parent/Guardian Name *

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Last

Phone Number *

Parent/Guardian

Email *

Parent/guardian

Emergency Contact 1 *

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Last

Relationship *

Emergency Contact 1

Phone *

Emergency Contact 1

Emergency Contact 2 *

First

Last

Relationship *

Emergency Contact 2

Phone *

Emergency Contact 2

Agreement *

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Your Signature *

Clear Signature

Today's Date *