Registration Form Home / Registration Form Spring 2018 Registration Form I. Participant FormName:* First Last Email:* Date of Birth:* Mobile:*II. League ApplicationSpring Session 2018Choose Your Division:*Lunch League - Thursdays at Creve Coeur Ice RinkOver 40 League - Thursday evenings at Webster Groves Ice RinkNovice Division 5 - Sundays at Kirkwood Ice RinkMiddle Division 4 - Sundays at Creve Coeur and Kirkwood Ice RinksUpper Division 3 - Wednesday evenings at Creve Coeur Ice Rink*Over 40 League will have some games Wednesdays at Creve Coeur Ice Rink *Novice Division 5 will have some games on Wednesdays at Creve Coeur Ice Rink Friends/Team I would like to play with:See Section IV for instructions how to pay for your league fees.III. Emergency ContactName:* First Last Relationship:*Mobile Phone No:*IV. Enrollment$230 due by February 25th Payment can be made by cash, checks payable to Arch Hockey. Payments can be made through PayPal to email@example.com. (this option can be found on the registration page of the website) League fees will raise to $260 after February 25th. Mail Cash and/or Check (Payable to Arch Hockey) Thomas R Barnes c/o Arch Hockey 13014 Mason Estates Ct St.Louis MO, 63141V. General Guidelines for Players Players are required to wear full hockey equipment, including a half or full visor / cage. We highly recommend a helmet with a visor or full cage. League fees are non-refundable or transferrable, except by league approval. Games may be cancelled and / or rescheduled in the event of inclement weather. VI. Disclaimers and DeclarationsWith your signature below, you are affirming the following: I hereby declare that I have reached 18 years of age. I agree to the terms and conditions set forth in the ARCH HOCKEY LIABILITY WAIVER AND ASSUMPTION OF RISK AGREEMENT, and that I will formally execute said AGREEMENT prior to participating in any Arch Hockey Programs. I hereby declare that I am healthy, physically fit and suitable to participate in the activity. I hereby agree to abide by all rules and regulations of Arch Hockey and affiliated rinks. I understand that the sport of Ice Hockey comes with inherent risks of injury or death, and that I am voluntarily assuming all of these risks, known and unknown. I agree that Arch Hockey and affiliated rinks shall not be liable for any injury, death, loss or damage I may suffer in this activity. I agree to authorize Arch Hockey to use my portrait, voice and personal information as the purpose of promotion without further examination. I hereby declare that I have my own personal health insurance. VII. Remarks Please read carefully the Registration Information before your enrollment. Since accidents may occur during all recreational activities, interested parties should therefore take the above into full consideration before enrollment. Personal data collection statement: The personal data provided on this form will be used for the purpose of processing your application for the stated event. Health Insurance Company Name:*Policy No:*Player Electronic Signature*Date* This iframe contains the logic required to handle AJAX powered Gravity Forms.