2020-21 Jr. Rhino101 Winter Registration Form 2020-21 Jr. Rhino101 Winter Registration Form First Name * Last Name * Address * City * State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip * DOB * Age * 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Position * Forward Defense Goalie T-Shirt Size * YS YM YL YXL AS AM AL AXL Jersey Size * YS YM YL YXL AS AM AL AXXL Mom's Name * Mom's Phone * Mom's Email * Dad's Name * Dad's Phone * Dad's Email * Jr. Rhino101 Registration Fee * Jr. Rhino101 Winter Session Fee $230.00 Gear * Yes I need Gear No I don't need Gear Gear Rental Form: Please go to the menu page and click on Hockey Headquarters Equipment Form to rent gear. Years Played Hockey * 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Photo Release By checking this box, I grant to Rhino Hockey, LLC the right to take photographs of me 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 me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. By checking this box, I DO NOT grant to Rhino Hockey, LLC the right to take photographs of me in connection with the above-identified organization. Waiver * I assume all risks and hazards incidental to such participation and do hereby waive, release, absolve, indemnify, and agree to hold harmless Rhino Hockey L.L.C., the organization, sponsors, supervisors, participants, coaches, captains, officials, and its associates for any claim arising out of an injury of accident 2020-21 RHINO HOCKEY PROGRAM AAU HOCKEY CLUB CODE IS #WYD97Y. THIS NUMBER NEEDS TO BE ADDED TO YOUR AAU HOCKEY REGISTER YOUR AAU MEMBERSHIP SO YOU NUMBER IS CONNECTED WITH RHINO HOCKEY PROGRAM AAU HOCKEY Registration Link is on the Jr. Rhino101 information page. Click on the AAU Hockey Logo to register for your membership number. Insurance * Parent or Guardian Signature Date * reCAPTCHA Submit If you are human, leave this field blank.