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For a cool ice skating experience! 131 West Easy Street Simi Valley, CA 93065 805-520-RINK Our Zamboni's are Electric not Propane and Safe for Your Health NY Times Article & ESPN |
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IN-HOUSE SUMMER 2010 STARTS MAY 14 & 15 PLEASE RETURN THIS INFORMATION SHEET TO EASY STREET: WITH THE FOLLOWING: 1. PLAYER’S PAYMENT (MAKE CHECK PAYABLE TO “ICEOPLEX”) 2. SIGNED ICEOPLEX WAIVER FORM 3. REGISTER at WWW.USAHOCKEY.COM for the INSURANCE PLEASE PRINT CLEARLY Player’s Name_______________________________ Parent’sname_________________________Address _______________ City _______ St Zip _ Home Phone __ Work Phone __ Birth date _____ E-Mail _______ POSITION PREFERENCE (check one:
Please check one: [ ] Mite (2002 & younger) [ ] Squirt (2001-2000) *DUES: MITE $300.00 PeeWee (1999-1998) [ ] Bantam (1997-1996) [ ] SQUIRT AND ABOVE $400.00 CC#________________________________ GOALIE$200.00 USA Hockey most be done on line. At www.usahockey.com Exp. Date___________________________ Amount $__________________________ REFUNDS: There will be no refunds. Please make checks payable to “ICEOPLEX”. DUES COVER:
PLEASE READ CAREFULLY! WAIVER AND RELEASE OF LIABILITY EASY STREET ARENA/MANAGED BY ICEOPLEX, H.A.S. INC & AFFILIATED BUSINESSES (Hereafter referred to as “EASY STREET/MANAGED BY ICEOPLEX)
In consideration of being allowed to participate in any way in sports and other activities at or by ICEOPLEX/EASY STREET, the undersigned acknowledges and agrees as follows:
1. I acknowledge and fully understand that I will be engaging in activities that involve risk of serious injury, including permanent disability and death and severe social and economic losses which might result not only from my own actions, inaction’s, or negligence, but also from the action, inaction or negligence of others, the rules of play, or the condition of the premises or competition area or any equipment used, further, that there may be other risks not known to me or not reasonably foreseeable at this time. 2. I agree that prior to participating in any activity sponsored by Easy Street/Managed by Iceoplex. I will inspect the competition area and all equipment to be used, and if through my inspection, I determine that anything related to that activity is unsafe, I will immediately advise my coach or an official of Easy Street/Managed by Iceoplex, of this unsafe condition and will not participate until the condition is corrected. 3. I assume all foregoing risks and accept personal responsibility for the damages following such injury, permanent disability, or death. 4. I release, waive, discharge, and covenant not to sue Easy Street/Managed by Iceoplex, its affiliated clubs. Their respective administrators, directors, agents, attorneys, coaches, and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event, all of which are caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise. I HAVE READ THE ABOVE WAIVER AND RELEASE AND UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY. I ALSO AGREE TO ABIDE BY ALL RULES OF THE EASY STREET/MANAGED BY ICEOPLEX YOUTH HOCKEY PROGRAM.
Date: __________________ Signature: ___________________________________ Player
Signature:________________________________________ Parent or Guardian
YOUTH HOCKEY SUMMER 2010 14 Weeks Season A Youth Hockey Program That’s Fun! ¨ For All Hockey Players, Boys and Girls, Mite - Bantam MARINERS HOCKEY PROGRAM ¨ MITE - BANTAM ** SAVE $125 OFF REGULAR FEE MITE $300 * SQUIRT – BANTAM $400 * GOALIES $200
(USA Hockey registration on line at www.usahockey.com) *Must provide proof of USA Hockey at Registration 28 Total On-Ice Sessions 14 Practice sessions 14 Regular season games
Program Starts: Friday, May 14, 2010
For Further Information call Luc Beausoleil 805-520-7465 Ext 18 or www.luc@iceoplex.com
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