U21 Men - Hockey
This form is used for the on-ice U21 men sessions.
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Email *
Last Name of the Athlete *
First Name of the Athlete *
Date of Birth *
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Position *
2020-2021 Team/Association *
Emergency Contact Name *
Emergency Contact Phone Number *
Other Comments/Notes
Informed Consent
For summer skills sessions 2021 at KHDC, I have read the information found at https://www.ontario.ca/page/rowans-law-concussion-awareness-resources and understand that participation in sports, including those that will take place at summer camp, may result in injuries, including muscles, bones, joints, spine, tissues, head and concussions, and in extreme cases, could result in unconsciousness or death.  

While this sounds dramatic, it's in no way meant to intimidate or discourage participation in sports.  There exist extraordinary cases, such as sudden pediatric heart attacks in episodes of physical activities, and as such it is important that all parties have an understanding of risks associated with sports and physical activities.  

All safety measures applicable to the age group will be followed at the most appropriate standards (OPHEA, NSO, PSO or PHU) for safety and security in sports.  All lead coaches are also trained in First Aid to reduce the risk of aggravated consequences.  We endeavor to make our athletes lives better and that starts with ensuring their safety and wellbeing.  In spite of our best efforts, accidents happen and insurance is contracted for the purpose of these circumstances between KHDC and its customers.

If you have any questions or concerns about the risks involved, the policies and procedures that exist to keep your children safe, please let us know.
I have read, understood and I agree with the Informed Consent. *
I consent to the use of images and videos for promotional purposes by KHDC. *
A copy of your responses will be emailed to the address you provided.
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