2020-21 Jr. Rhino101 Winter Registration Form

YAKS BK COM

Bull Dogs COM

Timbers COM

Buddies COM

Silverback COM

Dragons Com

First Name *

Last Name *

Address *

City *

State *

Zip *

DOB *

Age *

Position *

T-Shirt Size *

Jersey Size *

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 *

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 *

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