The undersigned parent(s) or guardian(s) of the below-names minor or participant in the athletics/sports program and related events and activities at Mid-Hudson Civic Center, Inc.: 1. Acknowledge(s) that the participant will be engaging in activities that involve risk of injury and property damage and the undersigned agree(s) to assume all risk and responsibility in connection therewith. 2. Agree(s) to inspect the facilities and equipment and will advise the coach or supervisor of any unsafe condition and will instruct the participant to do the same and the participant will not participate until safety is restored. 3. Agree(s) to be responsible for providing the participant with protective equipment, including helmet. 4. Release(s) and discharge(s) the Mid-Hudson Civic Center, Inc., Civic Properties, Inc. and their officers, directors, employees, and agents from any and all claims, demands, actions and causes of action arising out of the activities to be engaged in by the minor, including without limitation, injuries to life, limb, or property. 5. Grants permission for the Mid-Hudson Civic Center to publish photos or videos of self and children to the website, on-line and off-line publications. I give Mid-Hudson Civic Center, Inc. the perpetual, royalty-free right to use photos or videos. No confidential member information shall be published. All photographs and video footage shall remain the sole property of MHCC, Inc. I understand that no compensation will me made for this use. In the case of a press release regarding a test passes or annual ice exhibition I do give permission to use my child’s full name. EQUIPMENT INFORMATION The following equipment MUST be worn at all times for Mid-Hudson Civic Center, Inc. Learn to Play Hockey: Ice hockey helmet with face mask, mouth guard, neck guard, elbow pads, gloves, athletic cup, shin pads, & shoulder pads. Players without the proper equipment will not be allowed to participate in on-ice events. I/WE HAVE READ THE ABOVE DISCLOSURE, WAIVER AND RELEASE AND UNDERSTAND IT AND SIGN IT VOLUNTARILY.
PLEASE PRINT FULL NAME OF PARENT/GUARDIAN BELOW