Mail to: Men’s Hockey Office, 501 East 38th Street, Erie, PA 16546 Mercyhurst Make checks payable to University

______Name (please print) 31ST Annual ______Address Laker Hockey ______City State Zip School Training the next ______Email address generation of athletes.

______Phone number Aug. 5 - 10, 2019

______Position

______Height Weight Age

Jersey Size (youth) q S q M q L q XL

Jersey Size (adult) q S q M q L q XL

______Years experience

______Youth hockey organization affiliate (if applicable)

Office Use Only

/ / ______/ / ______501 East 38th Street, Erie, Pa. 16546 Pa. Erie, 501 East 38th Street, / / ______/ / ______Mercyhurst University LAKER HOCKEY SCHOOL CLASSES CAMP WAIVER Aug. 5-10, 2019 • Mercyhurst Ice Center Classes will begin at 8 a.m. and continue through the day, with In consideration of being allowed to participate in the Rick the youngest age groups skating earliest. Players will be grouped Gotkin Laker Hockey School provided by and in conjunction Mites Squirts Pee Wees according to their age and experience. Depending on a student’s with Rick Gotkin Sports Program, Inc. and Mercyhurst University • • and any related events and activities, and further intending to be Bantams • Midgets • High School ability level, adjustments can be made to move to another group legally bound, the undersigned: at Coach Gotkin’s discretion. The Laker Hockey School, under the direction of Rick Gotkin, 1. Agrees that, prior to participating, they will inspect the Head Coach of the , will begin on Monday, facilities and equipment to be used, if any, and if they Aug. 5 and run through Saturday, Aug. 10, 2019. All sessions will believe anything is unsafe, they will immediately so advise SKILLS COVERED the supervisor in charge of such facilities and equipment be held at the Mercyhurst Ice Center located on East 38th Street and refuse to participate. in Erie, Pa. There will be a mandatory final registration at the Day Session Day Session 2. Acknowledges and fully understands that they will be Mercyhurst Ice Center on Sunday, Aug. 4, 2019 between 9 a.m. Mon. Puck Handling Fri. Week Review (groups I & II) engaging in activities that involve risk of serious injury, and noon. (If you are not from the Erie area, you can register on Tue. Passing Checking/Defense including permanent disability and death, and severe social Monday, Aug. 5.) Wed. Shooting (group III) and economic losses which might result not only from Sat. Final Scrimmage their own actions, inactions or negligence of others, or the The program will combine 2.5 hours of actual on-ice instruction. Thurs. Team Play condition of the premises or of any equipment used. The All phases of the game will be covered: skating, passing, puck undersigned further acknowledges that there may be other handling, team play, shooting, checking, as well as defensive and 3. Risks not known to Rick Gotkin Sports Program, Inc. and offensive positional play. A ratio of at least one coach per seven ABOUT THE COACH Mercyhurst University or not reasonably foreseeable at players will be maintained at all times. Each player will receive this time. Rick Gotkin is currently head coach of the Mercyhurst University 4. Assumes all the foregoing risks and accepts personal equal ice time, a camp jersey and a certificate of completion. NCAA Division I Hockey Program. He has been the head coach of responsibility for the damages following such injury, the Lakers for the past 31 seasons. Mercyhurst University hockey permanent disability or death. Group I - Mites and Squirts has appeared in 30 consecutive league playoffs. Included in the 5. Releases, waives, discharges and covenants not to sue 8 - 9 a.m. Power Skating past 30 years are six NCAA Tournament appearances (1991, 1993, Rick Gotkin Sports Program Inc., Rick Gotkin, Camp Staff or Mercyhurst University and its respective administrators, 9 - 9:30 a.m. Break/Snack 1995, 2001, 2003, 2005); two NCAA National Runner-up finishes directors, officers, agents or employees; other participants; 9:30 - 11 a.m. On-Ice (1993, 1995); League Playoff Champions (1995, 2001, 2003, 2005) or the owners, lessees or lessors of the premises and/or 11:15 a.m. Depart League Regular Season Champions (1995, 2001, 2002, 2003, 2005, equipment used to conduct the Rick Gotkin Laker Hockey 2014, 2017). School, to all of whom the benefits of this waiver and 8 - 9 a.m. Saturday Scrimmage release from liability shall inure, from demands, losses or Coach Gotkin was named Association Coach of damages on account of injury, including death or damage Group II - Pee Wees the year in 2014 and 2017, and was named the MAAC Coach of the to property, caused or alleged to be caused in whole or in year in 2001. Gotkin was a former assistant coach at Rensselaer and part by negligence of the releases or otherwise. 11:15 a.m. - 12:15 p.m. Power Skating participates in many USA Hockey - Mid-American District activities THE UNDERSIGNED HAS READ THE ABOVE WAIVER AND 12:15 - 12:45 p.m. Break/Snack and has served as a Select Festival Head Coach. RELEASE FROM LIABILITY, UNDERSTANDS THAT THEY HAVE 12:45 - 2:15 p.m. On-Ice GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN 2:30 p.m. Depart IT VOLUNTARILY. IF THE PARTICIPANT IS A MINOR, I HEREBY REPRESENT THAT I AM THE PARENT OR GUARDIAN OF THE 9:30 - 10:30 a.m. Saturday Scrimmage PAYMENT PLAN MINOR, AND I HEREBY ACKNOWLEDGE AND AGREE TO THE Cost $225. A non-refundable deposit of $75 is due at the time of FOREGOING ON BEHALF OF THE MINOR PARTICIPANT, IN MY INDIVIDUAL CAPACITY, AND IN MY CAPACITY AS PARENT Group III - Bantam/Midget & High School application. A second payment of $75 is due by July 15, 2019 and OR GUARDIAN OF THE MINOR PARTICIPANT. I FURTHER 2:30 - 3:30 p.m. Power Skating the final payment of $75 is due at hockey school final registration INDEMNIFY AND HOLD HARMLESS THE ABOVE NAMED ENTITY 3:30 - 4 p.m. Break/Snack on Sunday, Aug. 4, between 9 a.m. and noon at the Mercyhurst FROM ANY AND ALL LOSSES AND DAMAGES INCURRED AND/ Ice Center. If registration is paid in full by July 15, 2019, you may OR SUFFERED BY THE ABOVE NAMED ENTITY AS A RESULT OF A 4 - 5:30 p.m. On-Ice BREACH OF THIS REPRESENTATION. 5:45 p.m. Depart deduct 10% from the $225 fee. If more than one family member is attending, deduct 10% for each additional student. ______10:45 - 11:45 a.m. Saturday Scrimmage Print Name of Parent or Guardian

QUESTIONS? ______For more information call Coach Gotkin at 814-824-2542 or email Signature of Parent or Guardian [email protected]. ______Date