SRVC Hockey

SRVC HOCKEY CAMP

Official Camp Registration Packet

Required Document Review

Please review all documents below. You must acknowledge each one before continuing to the registration form.

I acknowledge I have read the Camp Discipline Policy.

I acknowledge I have read the Locker Room Policy.

I acknowledge I have read the Player Drop‑Off and Pick‑Up Policy.

I acknowledge I have read the Refund Policy.

I acknowledge I have read the Safety and Health Protocols.

Section 1 — Participant Information

Participant Name Date of Birth Age Age Level for the 2026-2027 Season Position USA Hockey Membership Number Jersey Size Parent/Guardian Name Phone Email Address

City

State

Zip

I acknowledge the above information is accurate.

Section 2 — Emergency Contact

Emergency Contact Name Relationship to Player Phone Number I acknowledge this emergency contact information is correct.

Section 3 — Medical Information

Primary Insurance Provider Policy Number Primary Physician Physician Phone Medical Conditions / Allergies Current Medications I acknowledge the medical information provided is accurate.

Section 4 — Liability Waiver & Assumption of Risk

I acknowledge that participation in ice hockey and related training activities involves inherent risks including collisions, contact with sticks or pucks, falls, physical exertion injuries, and facility hazards. I voluntarily assume all risks associated with participation in SRVC Hockey Camp.

I acknowledge and accept the liability waiver.

Section 5 — Release of Liability

I release and hold harmless SRVC Hockey Camp, directors, coaches, staff, volunteers, the host rink, and affiliated organizations from any claims or injuries arising from participation.

I acknowledge and accept the release of liability.

Section 6 — Medical Authorization

I certify the participant is physically able to participate. I authorize staff to obtain emergency medical treatment if needed.

I acknowledge and accept the medical authorization.

Section 7 — Concussion Awareness

I understand hockey carries concussion risks. If a concussion is suspected, the participant will be removed until medically cleared.

I acknowledge the concussion awareness policy.

Section 8 — Photo & Media Release

I grant permission for SRVC Hockey Camp to photograph or record the participant for promotional and marketing purposes.

I acknowledge and accept the media release.

Section 9 — Player Code of Conduct

Participants agree to respect coaches, staff, and players; follow safety rules; show sportsmanship; and refrain from bullying or unsafe conduct.

I acknowledge the player code of conduct.

Section 10 — Indemnification Agreement

The participant and/or parent agrees to indemnify and hold harmless the camp and affiliates from any claims or expenses arising from participation.

I acknowledge the indemnification agreement.

Section 11 — Signatures

Participant Signature Date Parent/Guardian Signature (if under 18) Date