Injury Form
Wilmington Tropical Storms
Parent/Guardian Injury Waiver and Liability Acknowledgment Form
Participant Information
Player Name: ______________________________________
Date of Birth: _____________________________________
Parent/Guardian Name: _______________________________
Address: ___________________________________________
City/State/ZIP: _____________________________________
Phone Number: ______________________________________
Email Address: _____________________________________
Acknowledgment of Risk
I, the undersigned parent or legal guardian of the participant listed above, understand that participation in hockey and related activities involves inherent risks, including but not limited to:
- Falls and collisions
- Contact with other players, equipment, boards, and ice surfaces
- Sprains, strains, fractures, and other injuries
- Serious injury or illness that may occur during participation
I acknowledge that these risks may result in injury, disability, or other damages.
Assumption of Risk
I voluntarily permit my child to participate in activities organized by the Wilmington Tropical Storms and knowingly assume all risks associated with participation.
Release of Liability
To the fullest extent permitted by law, I release and hold harmless the Wilmington Tropical Storms, its coaches, staff, volunteers, sponsors, affiliates, and facility operators from any claims, demands, actions, or causes of action arising from participation in team activities, except where prohibited by applicable law.
Medical Treatment Authorization
In the event of an emergency, I authorize team officials to seek appropriate medical treatment for my child if I cannot be reached immediately.
Emergency Contact Name: _____________________________
Relationship: ______________________________________
Phone Number: ______________________________________
Medical Conditions/Allergies (if any): ________________
Parent/Guardian Certification
I certify that I am the parent or legal guardian of the participant listed above and have read and understood this document. I acknowledge that I am signing it voluntarily.
Parent/Guardian Signature: ___________________________
Printed Name: ______________________________________
Date: ______________________________________________
Team Use Only
Date Received: _____________________________________
Staff Initials: _____________________________________