If your captain has pre-paid for your team, please complete this form to verify you acknowledge the ARHL waiver. All players must agree to this waiver in order to be eligible to play.
WAIVER
To PARTICIPATE in Street/Roller Hockey at the Alexandria City Public Schools (ACPS) Hammond Middle School Rink managed by DC STREETHOCKEY, you must read the waiver below including the sportsmanship and fair play agreement below and agree to them.
We require every player to sign a waiver prior to participating at the rink or in leagues. All players in the adult leagues must at least 18 years of age to participate, unless they have a separate waiver form signed by a parent or legal guardian.
The waiver form helps players understand that there are risks associated with playing sports and that by participating in our events you are assuming these risks.
The information collected by us through the registration and waiver form is for the sole use of our organization and will never be sold or knowingly shared with third parties without your consent.
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ALEXANDRIA ROLLER HOCKEY LEAGUE LIABILITY WAIVER and SPORTSMANSHIP AND FAIR PLAY AGREEMENT
RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT. BY COMPLETING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ THIS CONTRACT CAREFULLY.
Group Organizer’s Name: ALEXANDRIA ROLLER HOCKEY LEAGUE and all of its recognized programs herein after referred to as ARHL TO: ALEXANDRIA ROLLER HOCKEY LEAGUE and all of its recognized programs herein after referred to as ARHL and Alexandria City Public Schools herein after referred to as ACPS RELEASE OF LIABILITY WAIVER OF CLAIMS & INDEMNITY AGREEMENT: In consideration of ARHL and ACPS permitting me to participate in its activities and sports, permitting me to the use of its equipment (if applicable) and permitting me the use of its facilities, I hereby agree as follows:
1. WAIVER: I, the participant/parent, agree to waive any and all claims that I have or may in the future have against ARHL and ACPS, and its directors, officers, employees, agents, representatives, assigns and successors. In completing this waiver form, I release J. Wayne Barrett, ARHL and ACPS from any claims or responsibility for injuries suffered in any activities or events conducted by ARHL, whether occurring within or outside of the facility. I knowingly assume all risks associated with participation, even if arising from negligence of the participants or others, and assume full responsibility for my (or my child’s) participation today and on all future dates.
2. RELEASE: I, the participant/parent, agree to release ARHL and ACPS, and its directors, officers, employees, agents, representatives, assigns and successors from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer, as a result of my participation in activities and sports offered by ARHL and ACPS, due to any cause whatsoever INCLUDING NEGLIGENCE, BREACH OF CONTRACT, AND BREACH OF STATUTORY DUTY OF CARE ON THE PART OF ARHL and ACPS and its directors, officers, employees, agents, representatives, assigns and successors.
3. HOLD HARMLESS AND INDEMNIFICATION: I, the participant/parent, agree to hold harmless and indemnify ARHL and ACPS, and directors, officers, employees, agents, representatives, assigns and successors from any and all liability for any property damage or personal injury to any third party, resulting from my activities and my participation in the activities offered by or associated with ARHL and ACPS.
4. CERTIFICATION: I, the participant/parent, certify that I am, or my child is, in good physical condition and can participate in sports and related activities, and I further agree that at any time I believe conditions to be unsafe, I will immediately discontinue further participation for myself or my child in the activity. If an emergency arises, I authorize the ARHL staff to request and/or administer medical treatment to myself, or my child, if necessary.
5. ASSUMPTION OF RISK: I, the adult participant, or minor participant and parent(s) or guardian(s), understand that all activities of ARHL include inherent risks that cannot be totally eliminated regardless of the care taken by ARHL and ACPS. I, the participant/parent know, understand, and appreciate the types of injuries inherent in ARHL activities, and hereby knowingly assume all inherent risks of the activities. Furthermore, as a participant/parent, on behalf of myself, my spouse, heirs, personal representatives, and assigns (releasing parties) do hereby waive, release, discharge and covenant not to sue ARHL and ACPS for alleged liability from any and all claims arising from the ordinary negligence of the protected parties. I am aware that participating in the activities and sports, without limitation, offered by or associated with ARHL and ACPS, exposes me to many inherent risks, dangers and hazards. By engaging in any activities offered by or associated with ARHL, I freely accept and fully assume all inherent risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting there from.
6. ACKNOWLEDGEMENT: I, the participant/parent, have read and understand this agreement. I understand that I am giving up substantial rights, including the right of the participant/child to sue for damages in the event of death, injury, or loss. I acknowledge that by willingly participating in any ARHL activities I am in de facto voluntarily signing the agreement, and intend my participation to be a complete release of all liability, including that due to ordinary negligence by the protected parties, to the greatest extent allowed by the laws of the Commonwealth of Virginia. That this Agreement shall be effecting and binding upon any heirs, next of kin, executors, administrators and assigns in the event of my death.
7. UNDERSTANDING: I have read and understood this Agreement prior to submitting, signing or emailing it. I am aware that by either submitting, signing OR emailing this Agreement, I am waiving certain legal rights which I or any heirs, next of kin, executors, administrators and assigns may have against ARHL and ACPS and its directors, officers, employees, agents, representatives, assigns and successors.
8. I affirm that I am 18 years of age or older (if under 18, must be signed by a parent or legal guardian).
9. SPORTSMANSHIP AND FAIR PLAY
a. I have read, understand and will abide by the rules of the ARHL and ACPS or program for which I'm registering.
b. I understand that I am responsible for my own fouls and behavior.
c. I understand that if it is reported by a referee, league official or an opponent that I have behaved in an unsportsmanlike manner or have not played by the rules that I could be suspended or expelled from the league with no refund.
d. I understand that my team captain is the only person from my team who can approach and address a referee or the opposing captain during a game. It is my responsibility to let my captain know of my concerns so he or she can appropriately address the concerns.
Please direct questions to: alexandriarollerhockeyleague@gmail.com
Select an option to continue with the registration.
