UHF Team Application

Team Name ____________________________________
Team Contact __________________________________
Email _________________________________________
Day Phone ____________ Night Phone _____________
Cell__________________

Waiver (Must Read):  I acknowledge that this activity has potential dangers in it.  In order t o participate in this activity, I agree to hold the facility harmless and waive any right to make claims or lawsuits against the facility or anyone working on behalf of the facility for any injuries or damages related to the alleged negligence of the facility.  This waiver does not apply to any injuries or damages that are the result of any willful, wanton, or intentional misconduct.  My participation in this activity is voluntary and I understand the effect of this waiver on my legal rights.

Print Name                          Sign Name & Date           USA Hockey #
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________
__________________  ________________   ____________