Please check the box below as an agreed signature for this waiver. An agreed to waiver by this registrant will be required before they can participate in this NSHDA activity or event.

Please note, by checking off the box, the registrant and parent or legal guardian has read and understands this Waiver and Release and agrees to and accepts all the risks and liabilities of this waiver and consent to treat form.

I, the undersigned, parent or legal guardian, acknowledge the inherent risk involved in ice skating, and all activities relating thereto. Accordingly, in consideration of myself, and/or the player, being allowed to participate in any skating activities and/or other activities while on the premises of any of the facilities that Northshore Hockey Development Academy (NSHDA) activities are held at. I agree to the following:

1. I acknowledge and fully understand that I and/or the player will be engaging in activities that involve risk or serious injury or damage which might result not only from myself and/or the player’s actions, but also from the action, inaction or negligence of others; and further, that there may be risks not known to me or not reasonably foreseeable. I also acknowledge and fully understand that the player cannot participate in any activities if they have recently suffered from any fever, sore throat, vomiting, diarrhea, or any other communicable symptoms or have been exposed recently to someone with COVID-19 or these symptoms. I further acknowledge that other participants in these activities may be incubating diseases including COVID-19 and may be capable of spreading diseases to others.

2. Covid Question: I, nor anyone in my household have had any of the following symptoms in the last 21 days: sore throat, cough, chills, body aches for unknown reasons, shortness of breath for unknown reasons, loss of smell, loss of taste, fever at or greater than 100 degrees Fahrenheit.

3. Covid Question: I, nor anyone in my household have tested positive for COVID-19 for at least 30 days.

4. On behalf of myself and my player, I agree to assume all the foregoing risks and accept personal responsibility for myself and my player’s own damages following such injury or sickness.

5. On behalf of myself (and/or the player), I release, discharge, waive and covenant not to sue Northshore Hockey Development Academy, Ryan Taylor, and all their respective agents, affiliates, associates, officers, directors, owners, facilities in use, employees and other players (collectively “releasees”) from all claims, demands, losses or damages on account of any sickness, injury, death or damage to property, caused or alleged to be caused in whole or in part by releasees, or any other party’s actions, inaction, or otherwise; and agree to indemnify releasees from any and all third party claims caused in whole or in part by myself (or the player’s) actions.

6. I agree that I shall provide health insurance to cover any personal injury and/or property damage sustained by my player while participating in any NSHDA activities or at any of the facility premises where NSHDA activities are being held. I give permission to have the player examined and treated by a qualified medical professional if he or she becomes injured in my absence.


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