CV Field Hockey Winter Youth Clinic
Girls in Kindergarten – 5th grade are invited to participate in the Cumberland Valley Field Hockey Winter indoor clinics

COME LEARN FROM THE 2023 MID-PENN COMMONWEALTH CHAMPIONS

WHEN: Thursdays from January 4, 2024 – February 29, 2024
WHERE: Eagle View Middle School gymnasium

TIME: 6:00 – 7:30pm

COST: $45. Checks made payable to CVFH Booster Club.  PayPal online payment also available.  

CVFH coaches and high school team players will coach all clinics
 Players should bring their own shin guards, mouthguards, and water
 Players may borrow a stick if a stick is needed
 The clinics will focus on learning and refining fundamental field hockey skills and work up
to small game play
 All levels of experience welcome

Questions? Contact Coach Ashley Hooper at CVFHCoach@aol.com
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Name of Person Completing this form *
Email of Person Completing this form *
Player Name *
Player Street Address *
Player Town *
Player Date of Birth *
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Player Grade *
Player School
Player allergies (environmental, food, etc.). Please write "none" if player has no known allergies. *
Player medical conditions that might require attention during the clinic time. Please indicate "none" if player has no known medical conditions.  *
Parent /Guardian Name *
Parent/Guardian email *
Parent/Guardian Phone Number *
Emergency Contact Name *
Emergency Contact Phone Number *
I affirm that I am the parent or legal guardian of the above named child, who has my permission to participate in the Cumberland Valley Youth Field Hockey Winter 2024 Clinic. I understand that Cumberland Valley Field Hockey Booster Club and all other coaches/staff/organizers/ volunteers are in no way legally liable for any injury to any
participant in this program.
 *
Do we (CVFH Booster club) have permission to e-mail you with future field hockey information?
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Photography waiver acknowledgement - Please know that the coaching staff will be taking photographs during the clinic time period.  Such photographs may be used on our social media platforms (Facebook, Instagram, Twitter).  Please read the below waiver and indicate your choice for your player.  This agreement is in alignment with the district's photo waiver.

I do hereby give permission for the CVFH Booster Club to use photos taken at the CV Youth winter clinics. I authorize CVFH Booster Club to use such photos in both print and/or electronic format. I agree that the CVFH Booster Club may use these photos for any purpose such as publicity, illustrations, advertising or web content. 
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The undersigned, in consideration of the opportunity to participate in the CVFH Booster Club Winter 2024 Clinic (the Clinic), and intending to be legally bound hereby, acknowledges and agrees that:
1. There are significant risks of injury associated with playing field hockey, including the possibility of serious
injury up to and including death;
2. COVID-19 is highly contagious, and a player attending a field hockey clinic may be exposed to or contract
COVID-19, which may result in serious illness up to and including death;
3. I knowingly and freely assume any risks to this player, both known and unknown, even if arising from negligence,
and I assume full responsibility for this player’s participation in the Clinic;
4. NOTWITHSTANDING THE RISKS of injury or COVID-19 associated with participating in the Clinic, I am
voluntarily allowing this player to participate in the Clinic with full knowledge of the potential dangers involved;
5. I hereby agree to accept and assume all risks of injury, illness, disability and/or death arising from the player’s
participation in the Clinic, whether caused by negligence or otherwise; and I release, waive, and discharge any
claims I may have arising out of this player’s participation in the Clinic;
6. I hereby indemnify and hold harmless CVFH, CVFH Booster Club, and all other
coaches/staff/organizers/volunteers against any and all claims, losses, damages, liabilities, judgments, or expenses
of any kind arising out of the player’s participation in the Clinic;
7. I willingly agree that this player will comply with the safety guidelines put forth by the Clinic, including wearing
a mouth guard, shin guards, and a mask at all times during the Clinic;
8. I hereby certify that this player is, to the best of my knowledge, in good physical and medical condition and allow
his/her participation in the Clinic at our own risk.
 *
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