Harding Hawks Field Hockey Club

HARDING HAWKS FIELD HOCKEY CLUB LLC 8 STACEY DRIVE ANNANDALE, N. J. 08801 908-730-7108

2015/6 WINTER CLINIC REGISTRATION

PLAYER’S NAME______

SCHOOL______GRADE______

PARENT’S EMAIL(PRINT)______

Please circle correct T-shirt size:

Youth S M L

Adult S M L XL

I(print)______give my approval to the participation of my child in any and all activities of the Harding Hawks Field Hockey Club LLC. I assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I do further release, absolve, indemnify, and hold harmless organizers, sponsors, its members, or any of the supervisors appointed by them, including coaches, from personal liability and, likewise, release from responsibility any person transporting my child to or from activities relating to their participation.

I further give permission, in my absence, for the coach or other adult appointee to secure medical treatment for my child, and give consent for my child to be treated by a physician and/ or taken to a hospital by the first aid squad, in order to secure medical treatment.

Signed: ______Date______

Make $350 check payable to: Harding Hawks Field Hockey Club LLC