L.O.S.A Waiver Form

L.O.S.A - C.K - 3on3 TOURNAMENT WAIVER FORM

All participants in the Lights Out Skating Academy - C.K - 3on3 Tournaments must complete and agree to the terms and conditions set forth in the waiver form below.

Parent Guardian Information

enter the parent/guardian information

First Name

Last Name

e-mail

Mobile Phone #

Home Phone #

Player Information

enter the player information

Team Name/Age Group

Player First Name

Player Last Name

Player Phone #

Player DOB

Player Level

Player Medical Information

enter the players medical information

Player Health Card #

Please list any medical or physical considerations for the player

Terms & Conditions

please check that you have read and agreed to terms & conditions below.

The participants and parents acknowledge and agree that Lights Out Skating Academy directors or instructors will not be held responsible for any accidents, damage, injury or loss however caused, negligent or otherwise, at any time and expressly any and all the aforementioned parties from all claims arising from any accident, damage, injury or as consequence thereof. In the event of an inability to be contacted, I hereby give Lights Out Skating Academy permission to seek any necessary medical attention needed.

I Agree

Lights Out Skating Academy has the right to use any photos for brochures,fliers or videos for website of any child.