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Game Times: To Be Determined (Based on Registrations)
Game Days: To Be Determined (Based On Registrations)
Game Location: 3200 Wonderland Rd S, London, ON
info@nhlstreetlondon.com
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Ken Casemore
2024-04-10T11:25:13-05:00
NHL Street Registration Form
Sign your child (ages 6-14) up for the first ever season of NHL Street Ball Hockey in London, ON for the month of June. The cost per player is $20.00 per game plus $50.00 for an NHL Reversible Team Jersey which they get to keep. Total Season Cost = $150.00 plus tax. Each game is one hour duration.
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Parent/Guardian Name
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First
Last
Home Address
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Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Parent/Guardian Phone
*
Parent/Guardian Email
*
Player Name
*
First
Last
Player Date Of Birth
*
Player Division (Age Group)
*
Choose Player Age Group
U8 - Born 2017 or 2018
U10 - Born 2015 or 2016
U12 - Born 2013 or 2014
Has Player Played in This League Before?
*
Yes
Yes, but I want to purchase a new jersey
No
Player Jersey Size
*
Choose Player Jersey Size
Have Jersey From Previous Season
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Medium
Adult Large
Adult X-Large
Player Favourite NHL Team
*
Choose Your Team
Anaheim Ducks
Arizona Coyotes
Boston Bruins
Buffalo Sabres
Calgary Flames
Carolina Hurricanes
Chicago Blackhawks
Colorado Avalanche
Columbus Blue Jackets
Dallas Stars
Detroit Red Wings
Edmonton Oilers
Florida Panthers
Los Angeles Kings
Minnesota Wild
Montreal Canadiens
Nashville Predators
New Jersey Devils
New York Islanders
New York Rangers
Ottawa Senators
Philadelphia Flyers
Pittsburgh Penguins
San Jose Sharks
Seattle Kraken
St. Louis Blues
Tampa Bay Lightning
Toronto Maple Leafs
Vancouver Canucks
Vegas Golden Knights
Washington Capitals
Winnipeg Jets
Player Skill Level
Selected Value:
1
(1 to 5, where 1 is never played before and 5 is played in a league before and scoring multiple goals per game)
Player Health Conditions
Terms & Conditions
*
I agree to the Terms & Conditions below.
WAIVER OF CLAIMS, RELEASE OF LIABILITY & INDEMNITY AGREEMENT
PLEASE TAKE YOUR TIME AND READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. BY SIGNING THIS DOCUMENT, YOU WILL GIVE UP LEGAL RIGHTS INCLUDING THE RIGHT TO SUE FOR ANY INJURY OR DAMAGES, HOWSOEVER CAUSED.
IN CONSIDERATION of my entry upon the “NHL Street” located at indoor and outdoor locations in London Ontario and the facilities thereon (the “Facilities”) and in consideration of my ability to participate in any way in NHL Activities (as defined below), I hereby confirm and agree with NHL STREET, NAL Insurance, NAL Administrative Services and its employees, agents, representatives, volunteers, independent contractors, subcontractors, service providers, successors, and assigns (collectively the “Releasees”), as follows:
NHL STREET ACTIVITIES
Within this Agreement, the term “NHL Street Activities” means any and all activities, events, and services provided, arranged, organized, conducted, and/or made available by the Releasees to members of the public at or from the Facilities from time to time, including, without limitation, sports games, sports practices, sports drills, sports and athletic training sessions, games, practices, exercises, gym activities and games, fundraisers, meetings, social gatherings, parties, tournaments, events, travel and transportation to/from NHL Street events, and any such other activities that that are inherent to and/or related to NHL Street activities.
ACKNOWLEDGMENT AND ASSUMPTION OF RISK
I am aware that my entry upon the Facilities and participation in the NHL Street Activities involves risks and dangers that may directly or indirectly cause injury and, in some cases, death, and loss of, or damage to, personal property. These risks are inherent to the NHL Street Activities and cannot be eliminated without altering the character and value of the NHL Street Activities. The risks may include, but are not limited to: slips/trips and falls; falls from heights; impacts with other people; impacts with the ground or other structures and equipment; physical fights; contracting a Communicable Disease (as hereinafter defined) the failure, malfunction and/or hazards present and/or created by equipment, structures, and facilities including, but not limited to, baseball bats, baseball gloves, bases, tees, baseballs, soccer balls, footballs, pitching machines, practice equipment light standards, fencing, helmets, cleats, bleachers, and parking lots, safety nets, entanglement, recreational facilities; obstructions, obstacles and/or hazards at any facility or location where NHL Street Activities take place; and negligence, want of care, omissions, failure to warn, failure to rescue, and/or failure to supervise by persons including, but not limited to, the Releasees, coaches, players, participants, parents, spectators, managers, and/or staff/employees of baseball teams, soccer teams and/or football teams.
Such risks and dangers may result in injuries including, but not limited to, the following: head trauma; concussion; fracture; sprain, strain and/or tear of bodily tissue; bruising; laceration and/or scrapes; dislocation; infection and/or Communicable Disease; blindness and/or loss of vision; loss of hearing; dizziness and disorientation; cardiac events, such as stroke, aneurism, or cardiac arrest; physical or emotional injuries; emotional distress, anxiety, depression and/or post-traumatic stress; choking; seizures; impalement; dirt or gravel in the eye(s); inhalation of noxious substances; allergic reactions and anaphylaxis; and burns.
For greater clarity, “Communicable Disease” means any disease which can be transmitted by means of any substance or agent from any organism to another organism where the substance or agent includes, but is not limited to, a virus (including but not limited to COVID-19, ifluenza, and/or MRSA), bacterium, parasite or other organism or any variation thereof, whether living or not, and the method of transmission, whether direct or indirect, includes but is not limited to, airborne transmission, bodily fluid transmission, transmission from or to any surface or object, solid, liquid, or gas or between organisms, and the disease, substance, or agent can cause or threaten bodily injury, illness, emotional distress, damage to human health, human welfare or property damage.
I AM AWARE OF AND UNDERSTAND THE RISKS AND DANGERS ASSOCIATED WITH THE NHL ACTIVITIES AND I FREELY ACCEPT AND FULLY ASSUME ALL SUCH RISKS AND DANGERS AND THE POSSIBILITY OF PERSONAL INJURY, DEATH, PROPERTY DAMAGE, AND/OR LOSS RESULTING THEREFROM.
RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY
I expressly agree as follows:
I am in good health and am physically and mentally capable of participating in NHL Activities in which I intend to participate;
To observe and comply with all rules and warnings, both general and activity-specific, including those which may be made visually, orally, or demonstrated by the Releases;
TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the Releasees and TO RELEASE the Releasees from any and all liability for any loss, damage, expense or injury, including death, that I may suffer, or that my next of kin may suffer resulting from my participation in the NHL Activities, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BRACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE UNDER THE OCCUPIERS’ LIABILITY ACT, R.S.O. 1990, c. 0.2, as may be amended from time to time, AND ALSO INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS REFERRED TO ABOVE;
TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all claims, demands, or causes of action, which are in any way connect with my participation in the NHL Street Activities, including any such claims which allege negligence acts or omissions of the Releasees;
In the event of my death or incapacity, this Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns, and representatives; and
In entering into this Agreement, I am not relying upon any oral or written representations or statements made by the Releasees with respect to participating in NHL Street Activities, other than as expressly set forth herein.
I am aware and agree to comply with all local and Provincial health orders and By-laws while in attendance of NHL Street as both a spectator and/or participant
CONSENT TO USE OF IMAGE AND LIKENESS
I acknowledge that the Releasees may take photographs and/or video recordings of me while I am participating in NHL Street Activities. I hereby grant the Releasees express permission to use my name, likeness, image, voice and/or appearance, as such may be embodied in any photographs, video recordings, digital images, and similar media, taken or made by the Releasees. I agree that the Releasees shall have complete ownership of such media, including all copyrights, and may use same for promotional purposes, including on websites or social media accounts maintained by the Releasees and on physical advertising or informational materials, such as brochures, pamphlets, postcards, inserts, and articles. I acknowledge that I will not receive any compensation for the use of such media and hereby release the Releasees from any and all claims which arise out of or are in any way connected with such use.
CONSENT TO MEDICAL SERVICES
I understand that the Releasees, through an authorized service provider, may, in certain circumstances, make on-site medical services available to me. I consent to the provision of such services to me in the event that I am injured while participating in NHL Street Activities.
PARTICIPATION BY MINOR(S)
If I am signing this Agreement on behalf of one or more person(s) who are under the age of 18 years (each, a “Minor”), I confirm the following:
I have entered the full legal name and date of birth of each Minor in the requisite fields below;
I am the parent or legal guardian of each Minor, or otherwise have the necessary legal authority to enter into this Agreement on behalf of each Minor, and hereby accept all of the terms and conditions contained in this Agreement on behalf of each Minor;
I have assessed the risks and dangers associated with the NHL Street Activities, having regard to the specific abilities and circumstances of each Minor, and I voluntarily consent to each Minor participating in the NHL Street Activities, despite such risks and dangers; and
If any Minor is injured while participating in NHL Street Activities, I accept all responsibility and liability for any such injuries and agree to defend, indemnify and hold harmless the Releasees from any and all claims or suits for personal injury, property damage or otherwise, which are brought by or on behalf of the Minor, and which are in any way connected with the Minor’s participation in NHL Street Activities.
GENERAL
I HAVE HAD SUFFICIENT OPPORTUNITY TO READ THIS ENTIRE AGREEMENT AND I AGREE TO BE BOUND BY ITS TERMS.
I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT, I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS, AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.
If, for any reason, any portion of this Agreement is found to be void, unenforceable, or inapplicable, the remaining portions shall remain in full force and effect.
This Agreement shall be governed and interpreted in accordance with the laws of the Province of Ontario, Canada.
This Agreement represents the entire agreement among the parties with respect to the subject matter hereof and there are no ancillary representations, warranties, covenants, agreements, or provisos.
This Agreement may be executed by electronic means.
I acknowledge having received a copy of this Agreement.
Total
Order Summary
Item
Quantity
Total
There are no products selected.
Player Division (Age Group) - U8 - Born 2017 or 2018
1
$100.00
Player Division (Age Group) - U10 - Born 2015 or 2016
1
$100.00
Player Division (Age Group) - U12 - Born 2013 or 2014
1
$100.00
Player Jersey Size - Have Jersey From Previous Season
1
$0.00
Player Jersey Size - Youth Small
1
$50.00
Player Jersey Size - Youth Medium
1
$50.00
Player Jersey Size - Youth Large
1
$50.00
Player Jersey Size - Youth X-Large
1
$50.00
Player Jersey Size - Adult Medium
1
$50.00
Player Jersey Size - Adult Large
1
$50.00
Player Jersey Size - Adult X-Large
1
$50.00
Total
$0.00
$0.00
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