The risk of injury from the activities involved in playing Ice Hockey is significant, including the potential for permanent paralysis and death.  While particular rules, equipment and personal discipline may reduce this risk; the risk of serious injury does exist, and, as a parent or for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS _____________________________________________________, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors and advertisers; from any claims arising out of my or my child’s participation in these activities.

Signature: ______________________________