Registration Form Palouse Adult Hockey League USA Hockey Confirmation #: Date of Birth: Last Name: First Name: MI:

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Registration Form Palouse Adult Hockey League 2017 2018 PLAYER INFORMATION USA Hockey Confirmation #: Date of Birth: Last Name: First Name: MI: Address: City: State: Zip: Preferred Phone: Alternate Phone: Email: Gender: Male Female SUB LIST Should we include your name, phone number, and email on the sub list posted at the rink? Yes No COST (does not include USA Hockey fee) A-League Full Season (individual): Goalies (with/without gear): $375 (tax included) $200 (tax Included) Payment method: Cash Credit Card Check (make payable to Palouse Ice Rink) All other Leagues Team Fees are $3,400 (tax included) Fees will be paid to Captains directly. The cost will be determined by the amount of players on your team

PALOUSE ADULT HOCKEY LEAGUE PLAYER AGREEMENT This agreement is by and between the Palouse Ice Rink, Inc. ( PIR ) and the individual registering to participate in the Palouse Adult Hockey League ( Player ). Player is responsible for reading the rules, policies, and conduct requirements listed below, and signing below acknowledges Player s understanding of and agreement to adhere to the rules, policies, and conduct requirements. General Rules All players must be registered with both the league and with USA Hockey. Officials enforce the rules in accordance with USA Hockey. Games are 5-on-5 (four skaters and a goalie). A Division Teams will be formed using a draft. The A Division season will consist of 18 games, plus a playoff of two guaranteed games ( not double knockout). B Major Division Teams will be formed by current standards of captains building a team; however, if in the opinion of the league coordinators there is an imbalance of substantial power, players may be moved to create better competition. Individual registrants may be added as space allows. The season will consist of 19 games, with the with a round robin playoffs of the top 4 teams. B Minor Division Teams will be formed by current standards of captains building a team; however, if in the opinion of the league coordinators there is an imbalance of substantial power, players may be moved to create better competition. Individual registrants may be added as space allows. The season will consist of 20 games. C Division Teams will be formed and follow the same rules regarding movement of players as in the B Division. However, if a player is obviously able to play at the higher level, effort will be made to move her/him to the higher division. Individual registrants may be added as space allows. There will be a three-goal limit for C Division players. This is a beginner division and is designed to encourage participation by everyone. All division games will have three 17-minute, run-time periods; however, if a game starts late, the length of one or more periods will be shortened so the game finishes on time. Games have a set time limit and must be completed on time.. Teams will switch ends between periods. There will be no time-outs during regular season play. Each team must begin the game with at least five (5) players. It is the responsibility of the team captain to ensure the scorekeeper has accurate names and numbers for his/her team players and substitutes prior to the start of the game. Each team must have like-colored jerseys with a unique number. If a team does not have a set of jerseys, the rink can provide them for an additional cost. Blue line icing. No checking ( not no contact). No shots originating above the waist. No slap shots. In the event of a tie, the tied score stands, and each team will receive one (1) point. If a player receives three penalties of any kind (not a game misconduct) in one game, that player will be out for the remainder of the current game. Per USA Hockey rules, a player assessed a game misconduct will be suspended for the remainder of the

current game, plus her/his next scheduled game; the player will not be allowed to sub in a game until s/he has sat out her/his next scheduled game. The adult league coordinators have the right to impose additional sanctions against a player following a game misconduct, including suspension from the league for the remainder of the season without refund. After the third misconduct during the season, a player may be suspended from the league for the remainder of the season without refund. Any player who engages in a fight will receive an automatic two-game suspension; a second fight during the season will result in suspension from the league for the remainder of the season without refund. Players must leave the building when asked to do so by an on- or off-ice official. After a whistle, off-ice officials may identify to an on-ice official an unsportsmanlike penalty for foul language. Substitution Policy The sub fee for league players is $10 per game, payable to the rink PRIOR to the start of the game. The sub fee for non-league players is $20 per game. Non-league subs must provide proof of current USA Hockey registration. If there is misbehavior from a non-league player, that player will be asked to leave, and the hosting league player will sit out his/her next scheduled game. League players may sub in their respective divisions or in a higher division. A sub may score a maximum of two goals during a game. A team should not exceed the total number of players on its regular roster when including a sub. (If a team ends up with extra players including subs the captain of the opposing team must approve them.) With prior approval by the opposing team s captain, a team may include one or more subs to bring its roster up to a total of nine (including the goalie). Non-compliance of any of the sub policy rules may result in a forfeit by the offending team. A player who has been assessed a game misconduct cannot sub for another team until s/he has sat out her/his next scheduled game. General Conduct Players are to conduct themselves in a manner that is respectful of all players, on-ice officials (referees), off-ice officials (time-/scorekeepers), and equipment. Players are to refrain from yelling, jeering, threatening, or swearing at other players or officials. Players are to refrain from arguing with refs during a game. (Rule 601 is clear on this, please review it.) Players are to refrain from violence or undue roughness directed at other players, officials, or equipment. Use of tobacco products and alcohol are not permitted in the bench area at any time. HAVE FUN and enjoy recreational hockey! I,, hereby agree to the above rules, policies, and requirements: Signature: Date: RINK CONTACT INFO Palouse Ice Rink Website: www.palouseicerink.com 1021 Harold Street Email: adulthockey@palouseicerink.com P. O. Box 8023 Moscow, ID 83843 (208) 882-7188 MEDICAL CONSENT AND RELEASE OF LIABILITY This is to verify that on this day of, 2015, I,

, give my consent to the Palouse Ice Rink, Inc. and its representatives to obtain medical care for myself from any licensed physician or clinic should an injury occur while participating in this skating activity. By signing below, I hereby release and discharge the Palouse Ice Rink, Inc. and USA Hockey from any and all claims for personal injury. Do you have medical insurance? No Yes Name of Insurance Carrier: Policy No: Do you have any medical conditions? No Yes (list below) Are you currently using any medication? No Yes (list below) Emergency Contact Name: Phone: Signature:

USA HOCKEY ONLINE REGISTRATION INSTRUCTIONS All adult league players and subs are required to register with USA Hockey online. If you have any problems or questions about online registration after reading the below information, please contact the Palouse Ice Rink at (208) 882-7188. 1. Go to www.usahockey.com ; hover over MEMBERSHIP and click on Register Online (under USA HOCKEY REGISTRATION heading) 2. Click on REGISTER NOW 3. You must be at least 18 years of age to process a registration. Check the box that acknowledges you are 18 years or older. 4. Under REGISTRATION TYPE select Ice Player/Coach 5. Follow the remaining prompts and fill in/provide all information 6. Process payment (using credit or debit card Visa, MasterCard, Discover, or American Express) 7. Print your confirmation page ( it should also be emailed to you after you complete your registration) 8. YOUR USA HOCKEY CONFIRMATION NUMBER MUST BE TURNED IN WITH YOUR ADULT HOCKEY LEAGUE REGISTRATION FORMS!