PO Box 723, Sparta, NJ 07871

Online Registration

Sparta Youth Ice Hockey
P.O. Box 723, Sparta NJ, 07871
spartahockey@spartahockey.com
http://www.spartahockey.com

Spring 2010 REGISTRATION

Squirt $325, Peewee/Bantam/Midget $350

Payment due with registration.

Payment can be made online with a credit card via our web store or with a check sent to the above PO Box.

Please make checks payable to Sparta Youth Ice Hockey.

*Players Name *Street address *Town *Zip Code *PARENT/GUARDIAN NAME *Home Phone *Cell Phone *EMERGENCY CONTACT (NAME/PHONE/RELATIONSHIP) *PARENT’S E-MAIL ADDRESS (ES) *Grade *SCHOOL High School Planning to attend if in 8th Grade Can we Share information with your future high School
Yes
No
*Age *Date of Birth *Position
Forward
Defense
Goalie
*Level (Year of Birth)
Squirt 10 & under
Peewee 12 & under
Bantam 14 & under
Midget (going into grade 9-12)
*USA HOCKEY REGISTRATION # *I give my child/ward (name) *Permission to Participate in the Sparta Youth Ice Hockey Program
Waiver and Release of Liability: In consideration of being allowed to participate in any way in Sparta Youth Ice Hockey, hereinafter referred to as SYIH, the hockey program, and related events and activities, the undersigned: 1) Acknowledges and fully understands that each participant will be engaging in activities that involve risks of serious injury which might result from their own actions, inactions or negligence of others, the rules of play, or the condition of the premises or any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. 2 ) Assumes all of the foregoing risks and accept personal responsibility for the damages following such injury. 3) Releases, waives, discharges, and agrees to hold harmless and covenants not to sue SYIH, their respective administrators, directors, agents, coaches, and other employees of the organization, other participants, sponsors, and if applicable, owners and lessees and lessors of the premises used to conduct the event, all of which are hereinafter referred to as “releasees”, from demands, losses or damages on account of injury caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise. I also give consent to administer first aid and emergency transport to nearest medical facility. I agree to abide by all rules, regulations and policies as set forth by SYIH and USA Hockey. I also understand that registration of my child does not necessarily guarantee that he/she has been accepted into the program until the final rosters are determined. I understand that all players are admitted into the program on a conditional basis pending acceptance on a first-come, first-served and/or a skill-based criterion. All fees paid to SYIH or USA Hockey are nonrefundable. The undersigned has read the above waiver and release, understand that they have given up substantial rights by signing it and sign it voluntarily.
*Parent Guardian *Date Volunteer support Interest/Skill
*By clicking on the submit button I hereby certify that I am the parent/guardian of the above named player and can legally agree to the above waiver and release of liability
Agree
Do Not Agree

PO Box 723, Sparta, NJ 07871

Online Registration

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