First Name*

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League* -40 +40 both

PLEASE CHECK THE BOX TO AGREE: Waiver & Permission to use photographs & video for promotional purposes: In consideration for the above-named skater’s participation in this program, skater and the undersigned agree to release Wexford County, Wexford County Civic Center, Boon Sports Management, and its employees and agents from all claims, damages and actions of the above-named skater or their parent/guardian. I understand and assume all risks for any bodily that may occur as a result of the inherent risk of skating. These risks may be caused by the negligence of the participant skater or the negligence of the other participants. I understand that any participant who causes damage or intentional injury will be suspended from the program without refund. I authorize Boon Sports Management to use all photos or videos taken of me/my child during any/all programs for advertising or promotional material. I have read and understand these terms and conditions and I agree to them.