Cincinnati

CINCINNATI, OH
Spring 2023 Program

* Indicates required field

Athlete's Name *

First

Last

Any Medical Conditions that impacts your son or daughter's ability to play sports? *

Parent's Name *

First

Last

Athlete's School *

Parent's Email (if providing more than 1 email address, please divide them with a comma) *

Athlete's current grade *

Parent's Phone number *

Athlete's Date of Birth *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Years of experience playing Field Hockey? *

Anything else you want us to know? (optional) *

Participant Waivers

1. Happy Hockey Organization RELEASE OF LIABILITY

In the consideration of the Happy Hockey Organization acceptance of the above participant in sport during the fall 2022 season, and in return for the opportunity to participate in this event:
I understand that a risk of participating in any sport, including field hockey, is the risk of injury, including but not limited to serious permanent injury, paralysis, exposure to COVID-19, and death. To minimize the risk of injury, we agree to tell our child to obey all safety rules and to report fully any problems related to her physical condition to the coaches as soon as the problem begins.
By accepting this waiver, I certify the following:

- That the participant is not currently under the care of a doctor for an injury or illness
that would prevent her safe participation in this event.
- That the participant is not currently being treated for or recovering from an orthopedic
injury that would prevent their safe participation in this event.
- That the participant does not have history of fainting or other problems related to strenuous
exercise; and
- That the participant is in good health and there is no reason that they cannot safely
participate in strenuous physcial activity.
In accepting your son or daughter, I do hereby agree that I shall be responsible for all costs associated with any injury or loss that may be sustained by your athlete as a result of his/her participation at the program. I also certify that they all have health insurance which provides adequate coverage for injuries or illness they may sustain while participating in the program.
By accepting this waiver, I also agree to release and promise not to sue the Happy Hockey Organization or their staff for any damages, loss, injury, or death arising from the participation in this program, unless such damages, loss, injury, or death are caused by willful and wanted conduct of such event staff.

By printing your name below, you are acklowleding that you understand and agree to all contents of the Happy Hockey Release of Liability Waiver *

2. Lindsay's Law

The Ohio Department of Health has announced new legislation referred to as Lindsay's Law which addresses Sudden Cardiac Arrest in youth athletes. The law went into effect on August 1, 2017. The following resources were developed to implement Lindsay’s Law:

Required Video
Required SCA Informational Handout

Please acknowledge that you have watched the Lindsay Law video and read the informational handout. *

Yes, I have watched the video and read the informational handout.

3. Ohio's Concussion Information Sheet

The Ohio Department of Health requires that all parents and athletes that participate in athletes read and understand the below document before the start of any athletic program or event:

Require Concussion Information Sheet

By printing my name below, I am acknowledging that I have read the Ohio Department of Health's Concussion Information Sheet and understand that I have a responsibility to report my/ my child's symptoms to coaches, administrators, and health care provider. I also understand that I/ my child must have no symptoms before return to play can occur. *

4. Usage of Photo Waiver

I give the Happy Hockey Organization permission to use my child in photos used for marketing purposes on their website, social media, or marketing materials.

Choose one *

Yes, I give my permission No, I do not give my permission

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Participant Waivers

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