This Waiver is in effect as long as the above player continues to attend the program(s) stated in this application

INSURANCE / WAIVER INFORMATION  (MUST BE COMPLETED TO PARTICIPATE)
MEDICAL/ INSURANCE COMPANY______________________________________________________

 In consideration of participating in any Hobomock Sports Center, Inc. activity, including Basic Skills, and Ice Hockey instruction, I represent that I understand the nature of the activity and that  I and/or my minor
child am qualified, in good health and proper physical condition to participate in such activity.  I acknowledge that if the conditions are unsafe, I and/or my minor child will immediately discontinue participation in
the activity.I fully understand that ice skating/ ice hockey involves risks of serious bodily injury, including permanent disability, paralysis and death, and that these and other risks may be caused by my own
actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the Releasees named below; and that there may be other risks either not known to
me or not foreseen 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 in the activity.
 I hearby release, discharge, and covenant not to sue the Hobomock Sports Center  Inc.., their respective administrators, directors, agents, officers, volunteers, and employees, or other participants (each
considered one of the Releases herein) from all liability claims, demands, losses, or damages on my 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 I further agree that if, despite this release, waiver of liability, and assumption of risk, I, or anyone on my and/or my minor child’s behalf, makes a claim against any of the
Releasees, I will indemnify, defend, save, and hold harmless each of the Releasees from any loss, liability, damage, or cost which may incur as the result of such claim. I have read this release and waiver of
liability, assumption of risk and indemnity and fully understand it.

Signature of Participant or
Parent/Legal Guardian ( If participant is under age 18)

Signed__________________________________________________  Date ________________

Printed Name_____________________________________________
POWER SKATING
Every Tuesday Night
March 7-August 22, 2017
6:40—7:40 pm    MITES / SQUIRTS
   7:50—8:50 pm    PEEWEE / BANTAM
WALK ON COST :  $ 11 per skater/ per hour
3 SESSIONS  
  Session #1      March 7 —April 25, 2017 (8 weeks) $80.00
   Session #2      May 2 — June 20, 2017 (8 weeks)    $80.00
     Session # 3    June 27—August 22, 2017 ( 8 weeks) $80.00
                                                     
NO  skating Tuesday July 4th
SPECIAL:
 ALL SPRING & SUMMER (24 WEEKS) $216.00

STICKHANDLING
Every Thursday Night
April 27 - August 24, 2017
5:30 — 6:30 pm    MITES / SQUIRT
      6:40 — 7:40 pm    PEEWEE / BANTAM
WALK ON COST :  $11 per skater/ per hour

 2 SESSIONS  
  Session #1      April 27 —June 15, 2017 (8 weeks)  $80.00
         Session #2      June 22— August 24, 2017 (10 weeks) $100.00
 
SPECIAL:
 ALL SPRING & SUMMER (18 WEEKS) $162.00

PEAK PERFORMANCE:   
ALL POWER SKATING AND STICKHANDLING SESSIONS March 7—August 24, 2017      $378.00



                          


                   Session #1                   PowerSkating                Stickhandling   

                  Session #2                   PowerSkating                Stickhandling

                                                                                          Session #3                   PowerSkating                                                                                                                           
       
                      Peak Performance *                                                                           

    *PEAK PERFORMANCE:   ALL POWER SKATING AND STICKHANDLING
                                                        SESSIONS March 7—August 24, 2017
                                                      
                                                                                                       
 Indicate Session Level Below:

                                                                                                             MITE/SQUIRT
                                                                                                                     PEEWEE/BANTAM
  HOBOMOCK ARENAS
POWER SKATING AND STICK HANDLING APPLICATION
Waiver must be signe
d

    Player Name_________________________________________________

    Street________________________________Town__________________
    
State________________Zip Code____________Phone______________
                             
Email_______________________________________________________                         
     
Parents Name(s): _____________________________________________
Previous Hockey Experience : ___
____________________________________________
 HOBOMOCK ARENAS
POWER SKATING AND STICK HANDLING APPLICATION
Waiver must be signed