NCRC’s Game Camp
Address: 186 Schoolhouse Rd, Ebensburg, 15931 Price: $200 (1 camp), $400 (both camps)
Sign in to Google to save your progress. Learn more
Which week(s) are you signing up for? *
Parent Name *
Skater’s Name *
Email *
Cell Phone Number #1 *
Cell Phone Number #2
Address *
Skater’s Date of Birthdate *
Years of skating experience *
How would you rate the skaters overall hockey ability? *
Liability *
In consideration of my minor child being permitted to participate in any way in the NCRC Game Camp, I agree:

1. I understand the nature of NCRC Game Camp activities and the Minor’s Experience and capabilities and believe the Minor to be qualified to participate in such Activity. I further acknowledge that I and the Minor are aware the activity will be conducted in facilities open to the public during the Activity. I further agree and warrant and will instruct the Minor that if at any time the Minor believes conditions to be unsafe, he/she will immediately discontinue further participation in the Activity.

2. I FULLY UNDERSTAND that (a) NCRC Game Camp activities involve risks and dangers of SERIOUS BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS, AND DEATH (“Risks”); (b) these Risks and dangers may be caused by the Minor’s 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; (c) 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 incurred as a result of the Minor’s Participation in the Activity.

3. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS NCRC Game Camp , their respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the “Releasees” herein) from all liability, claims, demands, losses, or damages on the minor’s account caused or alleged to be caused in whole or in part by the negligence of the “Releasees” or otherwise, including negligent rescue operations and further agree that if, despite this release, I, the minor, or anyone on the Minor’s behalf makes a claim against any of the Releasees named above, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE OR COST ANY MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

4. MY SKATER CAN FULLY DRESS THEMSELF WITH THE EXCEPTION OF TYING THEIR SKATES.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND IT’S TERMS, UNDERSTAND THAT I AND THE MINOR HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGNED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTENT IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW AND AGREE THAT IF ANY PORTION OF THIS AGREEMENT IS HELD TO BE INVALID THAT THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.
Required
Financial Agreement *
I/We agree that if at any time after acceptance of a position, your child withdraws from the program, declines the position, or is suspended or terminated for disciplinary reasons, you are still responsible for the entirety of the payment. The coaches and rink reserve the exclusive right to allow or disallow refunds on a prorated basis in cases of serious injury incurred while participating in an NCRC Game Camp on-ice activity or serious illness. (Injured or ill player must submit a written petition to the board with specifics of the condition and relief sought.)

In the event that any payment required under this agreement is not paid in full by DATE, you agree that your child will not be permitted to participate in any practice or activity until payment is made. You also agree that NCRC may notify governing organizations of amateur hockey (USA Hockey, PAHL) of any failure by you to make a required payment. No extensions of payments will be allowed.
Required
E Signature
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy