World Vision 4 on 4 Ball Hockey Tournament
Please read the waiver below and have all team members sign-off before submitting the
registration form. We must have all signatures before we can accept your team.
Waiver *All players must sign*
I affirm that I am participating voluntarily (or that I am the parent/custodian of a minor participating
voluntarily) in a Ball Hockey Tournament(the “Activity”) at World Vision Canada on their site located at 1
World Drive, in the City of Mississauga (the “Site”) on June 21, 2014, which has been organized by World
Vision Canada and the Ontario Ball Hockey Association (the ‘Parties’), at their own expense and in
consideration of being permitted to participate, I represent covenant and agree, on behalf of myself and
my heirs, executors, administrators, assigns, and any other person claiming, by under, or through me, as
follows:
1. I acknowledge that participating in the above noted Activity involves certain risks (some of
which I may not fully appreciate) and that injuries, death, property damage or other harm could occur to
me or others. I accept and voluntarily incur all risks of any injuries, damages, or harm which arise during
or result from my participation in the Activity. These risks include, but are not limited to, the possibility of
accident, injury or death arising out of participation in this Activity. I waive any claims to which I may
become entitled for any injuries, damages, losses or claims, whether known or unknown, which arise
during or result from my participation in the Activity, whether caused by negligence or otherwise. I release
and forever discharge the Parties, their officers, directors, agents and employees (the “Released
Parties”) from all such claims suffered by me as a result of my participation in this Activity.
2. I understand that the Activity is not being promoted, endorsed, sponsored or advocated by the
Parties in any way and that the Parties make no claims or representations with respect to the Activity or
whether my participation in the Activity is suitable for me.
3. I agree to indemnify and hold the Released Parties harmless from all losses, liabilities,
damages, costs or expenses (including but not limited to reasonable legal fees and other litigation costs
and expenses), of any nature and kind whatsoever, incurred by any of the Released Parties as a result of
any claims or suits that I (or anyone claiming by, under or through me) may bring against any of the
Released Parties.
4. I agree that this Release and Waiver of Liability, is intended to be as broad and inclusive as is
permitted by the laws of the Province of Ontario and that if any portion thereof is held invalid, it is agreed
that the balance shall, notwithstanding, continue in full legal force and effect.
5. I agree that this Release and Waiver of Liability shall be governed by and interpreted solely in
accordance with the laws of the Province of Ontario and no other jurisdiction. Any litigation relating to the
subject matter hereof shall be brought solely within the Province of Ontario.
6. I give my permission for the free use of my name and picture in broadcast, telecast or
written account of this Activity.
In Partnership with
And our Sponsors
Registration Deadline – June 6
Call 905-738-3320 for more details
World Vision 4 on 4 Ball Hockey Tournament
Playing for a Hurting World
Team Application Form
Please Print Clearly
Please Print Clearly
Team Name:_______________________________________________________________________
Team Contact:______________________________________________________________________
Email:_________________________________________________________________
Telephone:_________________________________________________________________________
Mobile:________________________________________________________________
Divisions Offered:
Men’s Open (OBHA A& B)
Junior (’96-’97)
Men’s OBHA C
Bantam (’98-’99)
Men’s OBHA D
Women’s OBHA B & C
Peewee (’00-’01)
Atom (’02-’03)
Individual Player Registration
Name
1.
Email
Birthdate (MM/DD/YY)
Last Level of Hockey
Waiver Sign Off *All players must sign*
2.
3.
4.
5
6.
7.
8.
9.
Please remit this form with the entry fee ($300 for team of 9). Every player must sign the form. We will accept teams on a first-come, first-served basis.
Mail to: OBHA: 56 Pennsylvania Avenue, Unit 5, Concord, Ontario, L4K 3V9. Fax (credit card only) to 905 738 3321. Email to [email protected]
Received ByY:_____________________________________
VISA
Mastercard
Amount: $__________________
Cash
Amex __________________________________________________________________
Cheque #__________________
Exp ______________________
Name on Card _____________________________________________________ Signature ________________________________________________________