UNITED FHC 2024 SPRING LEAGUE TEAM 

UNITED FHC 2024 SPRING LEAGUE TEAM at UNITED SPORTS

SAT MORNINGS *  3/16 – 4/27 * 7 WEEKS

REGISTRATION & PAYMENT - Complete this Form

 

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UNITED SPORTS LEAGUE AGE DIVISION
(Select same Division you are in for INDOOR 2022.23)     
*
Last Name *
First Name *
Date of Birth (Month/Day/Year) *
Age *
Family Contact Person *
Cell #1 * BEST # FOR SCHEDULE/WEATHER CHANGES (NAME & NUMBER)                                                                                                       *
Cell #2 * #2 PARENT CONTACT                                                                                                      *
Cell #3 * PLAYER NAME & NUMBER                                                                                                       *
email #1 *
email #2 * #2nd Parent Contact                                                  *
email #3: PLAYER'S eMAIL                                                                                                                                                                      *
Are you a current member of USA Field Hockey?               *
Are you a Goal Keeper? *

HELP!!!   WE ALWAYS NEED GKS to make this WORK!
Please recommend a GK to play with our Team
Include contact name, phone # & email

FH Club History:  Name of Current FH Club
GRADE  FALL 2023 *
School Attending Fall 2023 *

PLAYER's FEE PAYMENT

*

Sign & Date: 

Participant Agreement Release & Acknowledgment

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AND PARENTAL CONSENT AGREEMENT                                                                          

 I hereby release and discharge the UNITED FIELD HOCKEY CLUB and UNITED SPORTS TRAINING CENTER, its agents , employees, staff members, directors and officers from any claims, responsibilities or liabilities for injuries or harm incurred as a result of my participation and/or my child's participation as a player or spectator in programs and activities. 

 I fully understand that these activities involve risks and dangers of serious bodily injury,  sickness and disease (including communicable diseases), ("RISKS"), these Risks and dangers may be caused by my own actions or inactions, the actions or inactions of others participating in the activity, the condition in which the activity takes place or the negligence of the "RELEASEES" named below; there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs and damages I incur as a result of my participation or that of the minor in the Activity.                                                      

I authorize the United Field Hockey Club and UNTIED SPORTS TRAINING CENTER, its agents, employees, staff members, directors and officers to take whatever action is necessary, in their best judgment, in an emergency and I hereby release and discharge the United Field Hockey Club, its agents, employees, staff members, directors and officers from any responsibility or liability related thereto.                                                                                      

I hereby grant the United Field Hockey Club and UNITED SPORTS TRAINING CENTER permission to use my name, picture or likeness and/or my child's name, picture or likeness in any printed media or any form of advertisement.  I fully renounce any and all claims upon the United Field Hockey Club for reimbursement for use of this material.  (Sign & Date)*

Your answer



*

NOTE TO DIRECTOR - Send Message to Jill Dull
using this space
or send email to Jill Dull: UnitedFieldHockeyClub@aol.com

I have completed the Registration and Payment Options for the UNITED FH Spring Registration at United Sports;



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