Ice Dogs Team & Tournament Sign Up (Orillia Ice Dogs)

Waiver & Release of Liability

In consideration of participation in the Ice Dogs Spring/Summer Hockey program related events and activities,
the undersigned acknowledges, appreciates and agrees that:

1. Because of the nature of the sport, the risk of injury from activities involved with this program is significant and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injury does exist; and,

2. I knowingly and freely assume all such risks, both known and unknown and assume full responsibility for my participation; and,

3. I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I
observe any unusual significant hazard during my presence or participation, I will remove myself from
participation and bring such to the attention of the nearest official immediately; and,

4. I, for myself and on behalf of child, hereby release Ice Dogs Hockey Orillia, their managers, organizers, coaches, officials, assistants, other participants and if applicable, owners and lessors of premises used to conduct the event (Releasees) with respect to any and all injury or loss or damage to person or property.

I have read this release of liability and assumption of risk agreement; fully understand its terms and conditions.

This is to certify that I as a parent/guardian with legal responsibility for this participant, do consent and agree to
his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I
release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement
or participation in these program as provided above.

Name of Parent/guardian submitting: Signature by Acknowledgment