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Crouchy Alpha Hockey
c/o Derek Crouch
PO Box 824
Maineville, OH.
45039
alpha@crouchyalphahockey.com

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CROUCHY ALPHA HOCKEY - WAIVER OF LIABILITY

I AM AGREEING THAT I SHALL PROVIDE HEALTH INSURANCE (INCLUDING A COPY OF AN INSURANCE COVERAGE CARD OR SIMILAR DOCUMENT) TO COVER ANY PERSONAL INJURY AND PROPERTY DAMAGE SUSTAINED BY THE CAMPER WHILE PARTICIPATING IN ANY ACTIVITIES OF OR WHILE ON THE PREMISES OF CROUCHY ALPHA HOCKEY OR PREMISES LEASED OR OTHERWISE UNDER THE CONTROL OF CROUCHY ALPHA HOCKEY. THE UNDERSIGNED ASSUMES ALL RESPONSIBILITY FOR ANY AND ALL RISK OF DAMAGE OR INJURY THAT MAY OCCUR TO THE ABOVE NAMED PLAYER AS A PARTICIPANT IN CROUCHY ALPHA HOCKEY, INCLUDING PRACTICES, SCRIMMAGES, SKILLS SESSIONS, CLINICS, GAMES, TOURNAMENTS, USE OF TRAINING EQUIPMENT AND OTHER ACTIVITIES RELATED TO THE PROGRAM. ADDITIONALLY, THE UNDERSIGNED HEREBY RELEASES AND DISCHARGES THE PROGRAM, DEREK CROUCH, ITS OPERATORS, EMPLOYEES, AGENTS, SUPERVISORS, INSTRUCTORS, GUEST INSTRUCTORS AND OTHER PLAYERS FROM ALL CLAIMS, DEMANDS, RIGHTS OR CAUSES OF ACTION PRESENT OR FUTURE, WHETHER KNOWN OR ANTICIPATED AND RESULTING FROM OR ARISING OUT OF INCIDENT TO THE UNDERSIGNED PARTICIPATION IN SAID PROGRAM. THIS IS ALSO MY PERMISSION TO HAVE MY CHILD ADMITTED AND ATTENDED TO, FOR MEDICAL AND DENTAL TREATMENT, IN CASE OF SICKNESS OR INJURY. I HEREBY GRANT CROUCHY ALPHA HOCKEY THE RIGHT TO USE PHOTOGRAPHS, VIDEO IMAGES AND/OR OTHER MEDIA OF MY CHILD FOR PUBLICITY, ADVERTISING AND/OR OTHER COMMERCIAL PURPOSES. I UNDERSTAND THE EVENT MAY BE PHOTOGRAPHED, VIDEOTAPED OR OTHERWISE RECORDED, I AGREE TO LET THE ABOVE PARTIES USE MY NAME, PHOTO LIKENESS AND DEMOGRAPHIC INFORMATION FREE OF CHARGE IN ANY MANNER AND FOR ANY PURPOSE IN ANY MEDIA NOW KNOWN OR HEREAFTER CREATED.

CROUCHY ALPHA HOCKEY HAS A ZERO TOLERANCE POLICY WITH RESPECT TO UNCONTROLLABLE BEHAVIOR. ANY PARTICIPANT BEHAVING IN THIS MANNER WILL BE IMMEDIATELY DISMISSED FROM THE PROGRAM AND WILL FORFEIT ALL AMOUNT PAID. BY SIGNING THIS RELEASE AND BY BEING ENROLLED IN THIS PROGRAM YOU ASSENT TO THE ENFORCEMENT OF THIS POLICY AND YOU HEREBY GRANT CROUCHY ALPHA HOCKEY THE RIGHT TO INSPECT ANY AND ALL PERSONAL BELONGINGS AT ANY TIME ON OR OFF PREMISES IN RELATION TO THE PROGRAM. DATES, TIMES AND PRICES ARE SUBJECT TO CHANGE.