2016-17 Jr. Rhino Hockey101 Fall/Winter Registration 2017 Jr. Rhino Hockey101 Spring Session Registration 2017 Jr. Rhino Hockey101 Spring Session Registration Players First Name * Players Last Name * Address * City * State * Zip Code * Date of Birth * Players Age * 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Years played * 1 year 2nd year 3rd year 4th year 5th year 6th year 7th year 8th year 9th year 10th year 11th year 12th year 13th year 14th year 15th year Players Position * Forward Defense Moms Name * Moms Cell Phone * Moms Email Address * Dads Name * Dads Cell Phone * Dads Email Address * Session Options * Jr. Rhino 101 Fall Session Age 4-18 (Cost $200.00 if paid by Aug. 31st, $256 after Aug. 31st) Jr. Rhino 101 Winter Session 4-18 (Cost $226 if paid by Aug. 31st, $256 after Aug. 31st) Both Jr. Rhino 101 Fall/Winter Session Age 4-18 (Cost $372 if paid by Aug. 31st, $422 after Aug. 31st) Pay Your Registration with Credit Card A separate $25 check is required for a security deposit for your socks and jersey. The check will not be cashed unless these items are not returned at the end of the season. Please make your jersey deposit check payable to "Rhino Hockey" and mail to 4908 E Havenhill Drive, Sioux Falls, SD 57110. * Gear Rental * I require rental forward/defense equipment (An additional $50 fee is required for rental equipment. A separate $200 check for a security deposit is also required for all rentals) I will provide my own equipment Jersey Size - Jersey and Socks will be provided T-Shirt Size Waiver: I hereby give my approval for my child's participation in the Jr. Rhino Hockey Winter Session. I assume all risks, responsibilities, and hazards incidental to such participation and so hereby waive, release, absolve, indemnify, and agree to hold harmless Rhino Hockey L.L.C and its subsidiaries, sponsors, supervisors, paticipants, coaches, referees, Scheels IcePlex, and its associates for any claims arising out of an injury to my child. Also, my signature gives permissions for my child to be admitted and attended to for medical or dental treatment in case of injury or illness. * Checkboxes * By checking this box, I grant to Rhino Hockey, LLC the right to take photographs of my child in connection with the above-identified organization. I authorize RHLLC, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that RHLLC may use such photographs of my child with or without their name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. Insurance Carrier Parent or Gaurdian Signature * Today's Date * reCAPTCHA If you are human, leave this field blank.