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SKAGIT SPARTANS HOCKEY CLUB
Skagit Skate | 390 Cedar St., Burlington, WA 98233 |
www.skagitskate.com
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YOUTH HOCKEY LEAGUE REGISTRATION
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Youth Hockey League - Fall 2024
Youth Hockey League - Fall 2024
Player Information
Player Name
*
First
Last
Date of Birth
*
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Player Age
*
Please enter a number from
0
to
99
.
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Player Jersey Information
Please select size and choose 3 favorite jersey numbers (Numbers between 1-99 only)
Jersey Size
*
Select Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Jersey Number (First Choice)
*
Please enter a number from
1
to
99
.
Jersey Number (Second Choice)
*
Please enter a number from
1
to
99
.
Jersey Number (Third Choice)
*
Please enter a number from
1
to
99
.
Parent / Guardian #1 Information
Parent #1 Name
*
First
Last
Parent #1 Phone Number
*
Parent #1 Email
*
Parent / Guardian #2 Information
Parent #2 Name
First
Last
Parent #2 Phone Number
Parent #2 Email
Skagit Spartans Hockey Club: Risk/Danger Acknowledgment & Consent and Waiver Agreement
As the parent/guardian of (player listed on this form), I/we fully acknowledge that I/we have been informed of the risks and dangers associated with my child's participation in roller hockey activities and I/we hereby acknowledge that I/we fully understand the risks and dangers my child may be exposed to while participating in roller hockey. I/we further give my/our full consent and approval to my/our child to participate on a team in the SSHC. I/we do hereby waive, release, absolve, indemnity and agree to hold harmless the local team, league, conference and national (if any) roller hockey organizations along with the organizers, sponsors, coaches and other elected or appointed officers and supervisors, participants, employees and persons transporting my/our child to or from any activities, from and against any kind and all claims, costs, liabilities, expenses of judgment including attorney's fees and court costs arising out of my child's participation in SSHC activities, or illness or injury resulting there from, for any claim arising out of injury to my/our child. Whether the result of negligence or any other causes except for illness or Injury resulting from gross negligence or willful misconduct by any of the above.
Parent / Guardian Acknowledgment and Agreement
*
I Understand and Agree
Virtual Signature
*
Type Name to Agree
Date
*
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1932
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