NIR Power Skating

Full Name Player

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Format: (000) 000-0000.

Parent / Guardian 1 Name

Parent / Guardian 1 Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Parent / Guardian 2 Name

Parent / Guardian 2 Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Name

Parent 1 will be first call, Parent 2 will be second call, Emergency Contact will be third call

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please provide any medical conditions and/or allergies:

I allow NIR to use photos or video for promotional purposes:

E-mail

example@example.com

Level

Position

Current Association / Division

Parental Consent and Liability Waiver

In consideration of NIR Power Skating allowing me to participate, I agree and understand the following:

I understand that power skating involves high-speed skating, intense physical exertion, edge control drills, rapid directional changes, and potential contact with ice, the rink boards, goals, or other participants.
I acknowledge and fully assume all inherent risks, dangers, and hazards associated with power skating and dryland training, including but not limited to:
• Slips, falls, and collisions with the ice, equipment, or other skaters.
• Sprains, strains, fractures, concussions, and severe physical injury.
• In rare cases, permanent disability or death.

I agree that my child will strictly follow all safety instructions and rules set by the coaching staff.
• I confirm that my child will wear full, CSA-approved hockey equipment, including a certified helmet with a full face mask/visor and a neck guard, at all times on the ice.
• I understand that failure to follow safety rules or disruptive behavior may result in immediate dismissal from the session without a refund.
• To ensure safety, privacy, and compliance with Safe Sport guidelines, a female coach will only enter a co-ed or male dressing room to address the team when all players are fully dressed.
• To ensure sessions begin exactly on schedule and coaches can deliver full instructional time, all skaters must be fully dressed and ready to take the ice 10 minutes prior to the scheduled ice time.

To the fullest extent permitted by law and by my own free will, I (on behalf of myself and the participating minor) hereby release, waive, and forever discharge NIR Power Skating, its owners, instructors, employees, volunteers, participants, and facility operators from any and all liability, claims, demands, or causes of action arising out of any damage, loss, or injury.
I agree not to sue or make any claim against the released parties for any injury or property damage sustained during participation in the power skating program.

Cancellation Policy: All power skating classes and private lessons are final, non-refundable, and non-transferable. Make-up sessions are not provided for missed classes due to personal scheduling conflicts, travel, etc - with exceptions reserved strictly for documented medical emergencies, illnesses or severe player injuries.

Signature

My Products

Power Skating - 4 sessions

Dates May Vary

$220.00 CAD Quantity
Item subtotal:

Subtotal

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Total

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I have read and agree to the terms and conditions.