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NAME____________________________________________
ADDRESS_________________________________________
CITY__________________STATE_______ZIP___________
PHONE___________________________________________
EMAIL___________________________________________
ADULT EVENING SESSION
THURSDAYS (see schedule)
ANN
ARBOR ICE CUBE
$285
______ MAY 23rd - AUGUST 22nd
LIABILITY
WAIVER
I agree to release Steven Knuble, Michael Knuble, Bill Ellsworth, Assistant Instructors, Ann Arbor
Ice Cube, and West Shore Ice Arena from all claims, actions, causes of actions and damages by the undersigned person for the
loss or injury resulting directly or indirectly from the participation of such person in this hockey clinic. I further agree
to indemnify and save harmless such parties from all claims, actions, damages or demands, including all costs and expenses
incurred in defending any such claims or actions.
I fully recognize that participation in the sport of ice hockey can
be hazardous, even dangerous, and can result in minor or serious injury, even death. I have fully read this waiver and I acknowledge
a complete understanding of the contents of said waiver.
SIGNED____________________________________________
(Participant/Parent or Guardian)
DATE_____________________________
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