Fort Zumwalt West Inline Hockey Club

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1 Tryout Dates Season Tryout Date: January 20th, 2018 All players must prioritize and plan to attend this tryout session. If for some reason you can not attend, you must contact us ASAP at fzwinlinehockeyclub@gmail.com Times: Middle School Ages (Grades 4th-8th): 10:30am-12pm High School Ages (Varsity, JV & JV2/C teams): 11:30am-1pm Some High School players may be asked to attend the 2pm-3pm session as well. Location: Matteson Square Garden: 3051 Industrial Park Place W Drive. St. Peters, MO. (Directly behind Bowlero) Program Cost & Refund Policy Payment Method: Cash or Check or Credit (via PayPal) Note: All Credit Card payments will incur a 3% processing fee Payment Options: Pay in Full: $525 Payment Plan: See below Club Fee Payment Option (Applies to Forwards & Defense) First Payment: $125 Tryout Fee ( Non-Refundable ). Payment due at time of check-in at Tryouts. This also counts as your first club payment. Second Payment: $150 (Due on Feb 20th) - We will send more information on this later. Third Payment: $125 (Due on March 20th) Fourth Payment: $125 (Due on April 20th) Goalies: 100% Free to play this season (We need goalies) Jersey & Pant Policy & Fee (Applies to ALL Players - Forwards, Defense, Goalies) Jersey Fee: $136 (for both colors) Pant Fee: $40 Purchasing club jerseys and pants is mandatory for all. We will have this info available at Tryouts. Plan to order and pay then. These are the same style Jerseys and Pants that the players wore last year (If they still fit, then no action is necessary) Fundraising: We will distribute this information at Tryouts. Tournament Fee The club may participate in the Breakout Tournament. If we do, there will be an additional nominal payment required. Additional info to follow. Refund Policy No refunds will be allowed after payments have been made.

2 Right of Refusal of Service and Registration In an effort to maintain the highest standards of sportsmanship and to demonstrate the "Fort Zumwalt West Inline Hockey Club" as a leader in Missouri youth inline hockey both on and outside of the rink, the "Fort Zumwalt West Inline Hockey Club" reserves the right to refuse or return any registration for participation in any "Fort Zumwalt West Inline Hockey Club" programming if the "Fort Zumwalt West Inline Hockey Club" Executive Board determines said registration jeopardizes the goals and mission statement of the organization. A sufficient basis of any refusal or return of registration may be as a result of past or present conduct by the individual attempting to register, or any member of his/her/their family, extended family, former marital relationships, or his/her/their social networks. If an individual s prior conduct resulted in any disciplinary action against the aforementioned individuals by MOIHA, or any MOIHA affiliated organization/entity, any law enforcement agency or conduct which the "Fort Zumwalt West Inline Hockey Club" Board of Directors deems to not be in the best interest of youth hockey, the "Fort Zumwalt West Inline Hockey Club" reserves the right to refuse or return registration. In the event the "Fort Zumwalt West Inline Hockey Club" refuses or returns a registrant s registration, the "Fort Zumwalt West Inline Hockey Club" will provide the applying customer a written explanation outlining the decision. By signing below you are agreeing to accept the above terms and conditions. Parent / Guardian Parent / Guardian Full Legal Name (Print): Parent / Guardian Full Legal Name (Signature):

3 ALL INFORMATION REQUIRED. Player Information Player Name: Grade Player s Address: Player s Phone: (home) (cell) Player s Position: If you played for the Fort Zumwalt Inline Hockey Club last year, write down your current jersey number Jersey # If you are new to the club, we will let you pick from the list of available Jersey numbers during the Jersey ordering process. Mother Information Mother s Name: Mother s Phone: (home) (cell) Mother s Father Information Father s Name: Father s Phone: (home) (cell) Father s

4 Parent / Guardian / Waiver By signing below you are agreeing to accept the following terms and conditions. INSURANCE Parent/Guardian states and agrees that the player is adequately covered with medical insurance elsewhere and imposes no fault on this Association. WAIVER OF LIABILITY, RELEASE, ASSUMPTION OF RISK AND HOLD HARMLESS AGREEMENT The undersigned Parent/Guardian on behalf of themselves and the minor child/children participant ("participant") agree: (1) to indemnify and HOLD HARMLESS the "Fort Zumwalt West Inline Hockey Club" and its Board, along with the leagues in which they belong or subscribe, the officers, the coordinators, the managers, parents or any other individuals including those who transport them to and from practices/games ("the Release s") for any damages or injuries to the child as a result of their participation in the "Fort Zumwalt West Inline Hockey Club" and its programs or events; (2) to exempt, waive and release from liability for personal injury, property damage and wrongful death, including if caused by negligence (including the negligence, if any, of the Releasee s) the Releasee s and hereby do waive, release and relinquish any and all claims for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring to the participant, which arise out of participation in "Fort Zumwalt West Inline Hockey Club" events, member team activities, the sport of hockey, and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, causes of action that participant may have are hereby waived, released and relinquished. and the participant's parent/guardian acknowledge, understand and assume all risks relating to hockey and any member team activities and understand that hockey and related team activities involve risks to participant's person including bodily injury, partial or total paralysis and death, and damages that may arise therefrom and that I/we have full knowledge of said risks. The undersigned Parent/Guardian, participant and/or registrant acknowledge and agree that in order to communicate with members, prospective members and participants, the "Fort Zumwalt West Inline Hockey Club" and/or its Board members, officers, agents and coaches may, from time to time, send out information to individuals via fax, or other means. By registering below, registrant acknowledges, agrees and consents to receive communications in such manner. THE UNDERSIGNED AGREES NOT TO FILE ANY SUIT IN PURSUANCE OF ANY RIGHTS THEY MAY HAVE FOR ANY CLAIMS OR RIGHTS HEREUNDER OR OTHERWISE. By signing below you are agreeing to accept the above terms and conditions. I have carefully read and reviewed this Waiver, Release and Hold Harmless Agreement. I understand it fully and I execute it voluntarily. I,, the undersigned, represents to the "Fort Zumwalt West Inline Hockey Club" that I am the parent or legal guardian of the below participant and that the facts in this document concerning my child or ward are true and accurate. I hereby voluntarily give my permission for my child or ward to participate in the above noted Activity and agree individually and on behalf of my child or ward to the terms and provisions of this Waiver, Release and Hold Harmless Agreement and agree to be bound thereby. In the event of any medical needs I additionally give my consent to have my child treated accordingly. I have carefully read and reviewed this Waiver, Release and Hold Harmless Agreement. I understand it and I execute it voluntarily. Parent / Guardian Parent / Guardian Full Legal Name (Print): Parent / Guardian Full Legal Name (Signature): Proof of Insurance All participants must have proof of medical insurance, please fill out all of the information below: Insurance Company: Group Number: I represent and warrant that I have no known physical or mental condition that would impair my capability for full participation in the above noted Activity except for:.

5 Parent / Guardian / Photo Rights and Consent Parent and/or Player authorizes the "Fort Zumwalt West Inline Hockey Club" and/or its employees, assistants, or sub-contractors to photography or film/video Player and or Parent and to permit the use of display of said photographs or film/video in any publication, multimedia production, display, advertisement or world wide web publication. Parent/Guardian and/or Player agree that the "Fort Zumwalt West Inline Hockey Club" may use names, likeness, or biographical information. Parent/Guardian and/or Player releases and forever discharges "Fort Zumwalt West Inline Hockey Club", indemnifies and hold harmless the "Fort Zumwalt West Inline Hockey Club", its employees, coaches, managers, agents and other Parents from any and all claims, losses and damages which may be suffered or incurred in connection with the use of said photography or film/video, images including by not limited to, any claims for invasion of privacy of defamation. I give this consent with no claim for payment or commission. By signing below you are agreeing to accept the above terms and conditions. Parent / Guardian Parent / Guardian Full Legal Name (Print): Parent / Guardian Full Legal Name (Signature):

6 Parent Code of Conduct To Participate in "Fort Zumwalt West Inline Hockey Club" as a PARENT, I agree to: I will follow the clubs 24 hour rule. When I have any issue that I feel needs to be discussed with a coach, I agree to wait 24 hours after the event before contacting the coach in person, by phone or . I will treat my coaches, other players, opposing teams coaches, officials and fans with respect regardless of race, sex, religion or abilities. I will refrain from criticizing any decisions made by the coaches. I will refrain from coaching my child or other players during games and practices. I will encourage good sportsmanship from other parent, coaches, officials and players by demonstrating good sportsmanship myself. I will avoid saying or acting in any manner that will hurt, degrade or insult any player. I will emphasize the team's success over my child's individual accomplishments. I understand that I am representing "Fort Zumwalt West Inline Hockey Club" and will do my best to uphold the expectations placed upon me. I will accept responsibilities for all of my and my child's actions both on and off the rink surface. I will accept responsibility for any guests that come to a "Fort Zumwalt West Inline Hockey Club" event on my behalf. I will not use illegal drugs when I am at any "Fort Zumwalt West Inline Hockey Club" event, including out of town travel. If I am unable to resolve a concern with my coach (after observing the 24 hour rule), I will contact the appropriate board member. If I am ever asked by an official, rink personnel or "Fort Zumwalt West Inline Hockey Club" Board Member to leave a rink at any sanctioned event, I will report this incident to the "Fort Zumwalt West Inline Hockey Club" board within 3 days of the event. I will remember that my membership at "Fort Zumwalt West Inline Hockey Club" is a privilege and not a right. Furthermore, I understand that violations of the code of conduct may result in suspensions and probation. Multiple infractions or extreme violations of the Code of Conduct could result in removal from the "Fort Zumwalt West Inline Hockey Club" program or my "Fort Zumwalt West Inline Hockey Club" registration being refused next season. Parent / Guardian Parent / Guardian Full Legal Name (Print): Parent / Guardian Full Legal Name (Signature):

7 Player Code of Conduct To Participate in "Fort Zumwalt West Inline Hockey Club" as a PLAYER, I agree to: I deserve to have fun during my season and will alert my coach if hockey stops being fun for me. I will treat my coaches, other players, opposing teams coaches, officials and fans with respect regardless of race, sex, religion or abilities. I will not bully my teammates or other players nor will I participate in or support other players that are bullying players. I will encourage good sportsmanship from fellow players, coaches, officials and parents by demonstrating good sportsmanship myself. I will practice and play games with energy and enthusiasm but never in a dirty, reckless or dangerous manner. I will emphasize team success over my individual accomplishments. I will refrain from talking back to my coaches, officials and other parents. I understand that I am representing "Fort Zumwalt West Inline Hockey Club" and will do my best to uphold the expectations placed upon me at all times--including overnight trips I will not use tobacco, alcohol or illegal drugs when I am at any "Fort Zumwalt West Inline Hockey Club" event, including the hotel on overnight trips. I will accept responsibility for all my actions both on and off the rink. If I receive any misconduct or match penalty in a MOIHA sanctioned event, I will contact the "Fort Zumwalt West Inline Hockey Club" Board directly within 3 days of the penalty. I will remember that playing hockey for "Fort Zumwalt West Inline Hockey Club" is a privilege and not a right. Violations of the Code of Conduct could result in my suspension or my registration being refused the following season.

8 Missouri Inline Hockey Association (MOIHA) Player Code of Conduct MOIHA is very appreciative of the players time and dedication. All players are representatives of their team, individual school, and the league. In order to insure all players perceive their responsibilities in the same way, the following code of conduct and responsibilities have been developed. 1. Play for fun, it is just a game. 2. Work hard every time you are on the floor to improve your skills. 3. Be a team player get along with your teammates. 4. Be a disciplined player and always exercise good sportsmanship. 5. Be early for practices and games. 6. Learn the rules and play by them. 7. Respect your coach, teammates, opponents, officials, and parents. 8. Never argue with an official s decision. 9. Maintain academic eligibility at your school. 10. Be respectful of the rinks, locker rooms, and all other common areas of the facilities that you are playing at all times. 11. Do not use foul language or obscene gestures. 12. Never do anything that may be construed as taunting or unsportsmanlike to others.

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