Adult Picks Pick Ups

1
Rules

Every participant must be at least 18 years old.

Inline hockey skates ONLY (Not an ice rink).

Only water permitted on the rink and in the benches.

No food or other drinks permitted on the rink.

All trash must be taken at pick-up conclusion.

Full Gear Is Required - This includes helmet, shoulder pads, elbow pads, gloves, pants, shin guards, protective cup, and INLINE hockey skates.

Helmets must be worn at all times while on the floor and while on the bench.

The rink being on public school grounds is a drug and alcohol–free sports environment.

All participants must agree to the waiver form.
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Participant's Name* This field is required.
First Name
Last Name
3
Participant's Birthday* This field is required.
Date
Year
Month
Day
4
Participant's Age* This field is required.As of December 30, 2021
5
Phone Number* This field is required.
Please enter a valid phone number.
6
Participant's Email* This field is required.
example@example.com
7
I would like to receive emails about upcoming inline hockey activities and leagues
YESNO
8
Are you a goalie
YESNO
9
RELEASE AND WAIVER OF * This field is required.In consideration of being given the opportunity to participate in the "adult pick up inline hockey" activities, being held at the Top of Virginia Hockey Rink, located at James Wood Middle School, I for myself, my personal representatives, heirs and next of kin: 1. Acknowledge, agree, and represent that I understand the nature of skating activities and participating in the sport of hockey and hockey-related activities and exercises, and that I am in good health and in proper physical condition to participate in such activity. 2. Fully understand that (a) skating and hockey activities involve risks and dangers of bodily injury; (b) these risks and dangers may be caused by my own actions, or inactions, the actions or inactions of others participating in the activity, the condition in which the activity takes place, or the negligence of the releases named below; and (c) there may be other risks and social and economic losses either not known to me or not readily foreseeable at this time, and I fully accept and assume all such risks and all responsibility for losses, costs, and damages which may be incurred as a result of my participation in the activity. 3. Hereby release, discharge and covenant not to sue Top of Virginia Hockey Alliance, indemnify and save harmless the Top of Virginia Hockey Alliance, and its individual board members, and any other participant in the activity from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise, including negligent medical care; and further agree that if, despite this release and waiver of liability, assumption of risk, and indemnity agreement, I, or anyone on my behalf, makes a claim against any of these releases, I will indemnify, save, and hold harmless each of the releases from any litigation expenses, attorney fees, loss, liability damage, or cost which any may incur as the result of such claim.
Agree
Do Not Agree
10
Adult Pick Up Times* This field is required.
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ORDER SUMMARY
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Tuesday, June 2 | 7:00 pm - 8:30 pm
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