2018 FALL LEAGUE

2018 FALL LEAGUE

6 Fun Weeks of Skill and Competition

A GREAT way to learn the game!

Kindergarten through 8th grade

Game Location: Nansemond River High School

Saturdays ONLY

Session Dates: September 22, 29, October 6, 13, 20, 27 (November 3- make-up day, if needed)

Sessions will be divided by grade (K-5 – 2; 3- 5; 6-8)

Time will consists of individual skill practice, team skill practice, drills, and small games

All Athletes Will NEED: Shin guards, Mouthpiece and a Stick (goggles are not mandatory, but allowed)

League Cost: $90**

**Add Additional fee of $10 if registration is received after Sept. 10th!!!

NO REFUNDS after September 10, 2018

Return check fee: $35

Any questions?? Email Tara Worley- taworl@aol.com

TO PAY BY CASH OR CHECK, PRINT FORM BELOW AND MAIL IN WITH PAYMENT.

MAKE CHECKS PAYABLE TO: Girls Field Hockey

All Due Dates Still Apply!

Fall league 2018

Participant's Name*
Age (as of 5-1-18)*
High School Name (Only if signing up for HS division) Leave blank otherwise.
IF you are signing up to play with your high school team, please type the school name above.
Birthdate*
Grade (Fall 2018)*
Address*
City*
State*
Zip*
Phone*
Email*

*Parent's Email - Will be used to contact parents and athletes on schdules and other pertinent information.
Level of Experience*
What are you signing up for?*
Photo Waiver
- I have read and agree to the below Photo Release Statement
I understand and will allow photos and/or videos of me and/or my child to be taken while at this activity to be used in any Girls Field Hockey, Ltd. publications/social media. I also understand that publication of these photographs may be accomplished electronically via the Internet/World Wide Web and that after publication, Girls Field Hockey, Ltd. will be unable to prevent persons from gaining access to the Internet/World Wide Web, copying my photographs and video therefrom, and subsequently using, altering, or republishing it without my consent. I waive any claim for damages against Girls Field Hockey, Ltd. from unconsented use, alteration, or republication of my photographs and video by third parties accessing the Internet/World Wide Web.
Medical Care*
- I hereby authorize routine medical depensary care for the above-name athlete; and I authorize treatment not considered routine to be referred to local physicians and medical facilities at my expense.
Release of Liability/ Injury Waiver*
- I have read and agree to the below Realease of Liability/ Injury Waiver Statement
As a parent of a child participating in Girls Field Hockey, Ltd. organization, I retain medical expense responsibility and do hereby release, acquit, hold harmless and forever discharge GFH, its agents, agencies, servants and employees, and all persons, natural and corporate, in privity with them or any of them from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits, and/or claims form any bodily injuries, deaths, or property damage which may be sustained by , my child(ren) while participating in any activity, including travel to and from such activities, not resulting from the intentional tortuous act or acts of any agent, servant, or employee of GFH. It is acknowledged that the decision to engage in the above activities is entered into freely, and that GFH, its agents, agencies, servants and employees have not influences the decisions to engage in such activities.
Proof of Insurance*
- I hereby certify that the above name athlete is covered by a personal insurance policy or is included in a policy that I have in force.
As a parent of a child participating in Girls Field Hockey, Ltd. organization, I retain medical expense responsibility and do hereby release, acquit, hold harmless and forever discharge GFH, its agents, agencies, servants and employees, and all persons, natural and corporate, in privity with them or any of them from any and all claims or causes of action of any kind whatsoever, including but not limited to actions, suits, and/or claims form any bodily injuries, deaths, or property damage which may be sustained by , my child(ren) while participating in any activity, including travel to and from such activities, not resulting from the intentional tortuous act or acts of any agent, servant, or employee of GFH. It is acknowledged that the decision to engage in the above activities is entered into freely, and that GFH, its agents, agencies, servants and employees have not influences the decisions to engage in such activities.*
- I agree to the Terms of Service
Signature*
Total
$0.00