2022-2023 Norwin Inline Hockey Registration
Form must be completed by July 1st, 2022. Please mail your deposit check or money order of $250 to  P.O. Box 238, Irwin, PA 15642 by Friday, July 15th. (Checks payable to ‘Norwin Inline Hockey") A $25 fee will be charged on all checks returned for NSF. You can also pay by Venmo @Norwin-Inline . Lastly, the summer Pep Roll fundraiser timing is aligned to allow you to use proceeds for your deposit.

*Note: Once a player is placed on a team roster, the deposit becomes non-refundable. In the event a player is not placed on a roster, the deposit will be returned in full. We will do our best to place everyone within the roster guidelines as written in our club by-laws.

The submitter of this form must enter their email address below. Submitter will receive confirmation their information has been received and may retain for their records.
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Email *
SUBMITTER PARENT/ GUARDIAN INITIALS REQUIRED
In consideration of being allowed to participate in any way in this program, related events and activities, the undersigned acknowledges, appreciates and agrees that:
1. I understand the $250 deposit is non-refundable after July 15th, unless son/daughter is not able to be placed on a team roster. This would only occur if there are an inadequate number of players to form an additional team.

2. The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce these risks, the risk of serious injury still exists; and,

3. I knowingly and freely assume all such risk, both known and unknown and assume full responsibility for me/my child’s
participation; and,

4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe
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,

5. I for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless Norwin Inline Hockey, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, and advertisers with respect to any and all injury, disability, death or loss or damage to person or property, whether arising from the negligence of the released or otherwise.

INTENDING TO BE LEGALLY BOUND, I/we 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. (Electronic signature, payment via check and or receipt of registration transaction are all equivalent to a hand written signature.) Parent or Guardian's submitting this form please Initial below. *
USE OF PLAYER IMAGES
During the season, pictures and videos of players will be taken and these images may be placed on the club’s website, Facebook, Instagram, YouTube and other social media platforms.
Please check the appropriate box below *
Required
FUNDRAISING
ALL Players are REQUIRED to participate in our mandatory Fundraiser.
If necessary an additional mandatory fundraiser – i.e. an additional fundraiser may be required if the primary mandatory event above does not raise the necessary funds. Club members will be advised of such a fundraiser at least a month before it is to occur.• There will be optional fundraising opportunities throughout the season. The money from these optional fundraising events may be used to offset the individual member cost of the club fees.
Parent or Guardian submitting this form Initial below to acknowledge NIH fundraising. *
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