2018-19 Jr. Rhino101 Winter Registration

First

Last *

Address *

City *

State *

Zip *

DOB *

Players Age *

Number of Years Played Hockey

Mom's Name *

Mom's Phone *

Mom's Email *

Dad's Name *

Dad's Phone *

Dad's Email *

Session Options *

Jr. Rhino101 Winter Session Age 4-18 (cost $230.00 paid by Oct. 26th 2018 after Nov. 1st 2018 $255.00

AAU Hockey Numbers copy and paste this link in a browser AAU Hockey registration required.

AAU HOCKEY # *

Rhino Hockey AAU Hockey Club Number

Position *

Forward

Defense

Goalie

PAY WITH CREDIT CARD (COPY AND PASTE ON A NEW TAB)

Equipment Rental Options *

No I have my own gear

Yes I need to rent gear

Equipment Rental Link (Copy and paste to a new tab)

Jersey Size *

T-Shirt Size *

Jersey & Socks Deposit

Photo Release *

By checking this circle, 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.

No I dont want my childs photograph to be used for marketing material

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.

Insurance *

Parent or Guardian Signature *

DATE *

reCAPTCHA

If you are human, leave this field blank.