NASHA Membership Application General Information Welcome to NASHA Sports we provide insurance to the Hockey Schools, Leagues or Teams. You are a member of NASHA via your registration with one of those programs if you are a player, coach, instructor or administrator. You are required to register with NASHA so that we can track your participation in the sport in case there are any claims made. You will also receive many benefits by being a member as we have partnered with Players Health to provide Health and Safety to players, coaches, and instructors. Our Member Services Insurance Partner is Player's Health Cover Canada Inc and Player's Health Cover USA Inc. Select Role* PlayerCoachInstructor Coaches and Instructors, What Certification do you have? Coaches and Instructors, Do you have a clean Police Check within the last 2 years? yesno Name* Address* City* State / Province / Region* Zip / Postal Code* Email* Phone* Please let us know what programs you may be participating in. We know things may change so please just give you plans for the season as you know them now. You do not need to update us if things change. Participating on a Contact Spring/Summer Team Participating on a Non-Contact Spring/Summer Team Participating at a Hockey School Participating in a Camp Participating in a 3on3, 4on4, 5on5 League Name Of Program You Are Registered With In this section you are letting us know what NASHA Member you are registered with. We realize you might be with two programs, like a Hockey School but a different organization for a Spring/Team. Please let us know your best intentions at the time of registration. However, we are aware that intentions can change. You do not need to inform us of any changes as you are a member of NASHA no matter what member you play or train with. Contact Spring/Summer Team Non-Contact Spring/Summer Team Hockey School Camp 3on3, 4on4, 5on5 League Thank you for registering with NASHA. Through our partnership with Player's Health, every player participating in your programs will get FREE access to the Players Health APP by being a member of NASHA. PH Rehab is an injury management platform that helps organizations keep athletes safe. Create injury reports, manage concussion return-to-play, communicate updates, and reduce the risk of injuries falling through the cracks, from one app. Quickly and easily file injury reports using our mobile app or a desktop/laptop computer. Effortlessly communicate injury updates to all necessary parties with instant notifications when a change is made to an athlete’s record. Know when an athlete is ready to return from a concussion or head injury with our return-to-play system. Free abuse and misconduct reporting software that is private, anonymous and easy to use for coaches, administrators and athletes of all ages. Thank you for joining a NASHA member program, we wish you’re the best for a wonderful and safe time playing/coaching/instructing. You can contact Mark Hetherman at email@example.com if you have any questions. WAIVER: We do require to read the waiver below and to check the box at the end consenting that you have read the document and agreed you understand. READ BEFORE SIGNING WARRANTY AND CONSENT OF PARENT/GUARDIAN ASSUMPTION OF RISK RELEASE AND WAIVER OF LIABILITY INDEMNITY AGREEMENT IN CONSIDERATION of allowing my minor child/ward to participate in the program, related events and activities of a member of North American Spring Hockey Alliance (“NASHA”) I WARRANT TO YOU THAT: I am a parent/guardian having full legal responsibility for decisions regarding my minor child/ward, and I am familiar with the risk of serious injury and death which any participant in this program must assume, and I believe that my minor child/ward is physically, emotionally and mentally able to participate in this program and that his/her equipment is mechanically fit for his/ her use in this program, and I understand, and will instruct my minor child/ward, that all applicable rules for participation must always be followed and that the sole responsibility for personal safety remains with my minor child/ward, and I will immediately remove my minor child/ward from participation, and notify the nearest official, if at any time I sense or observe any unusual hazard or unsafe condition or if I feel that my minor child/ward has experienced any deterioration in his/her physical, emotional or mental fitness for continued participation in the program. I UNDERSTAND AND AGREE, ON BEHALF OF MY MINOR CHILD/WARD, MYSELF, MY HEIRS, ASSIGNS, PERSONAL REPRESENTATIVES AND NEXT OF KIN, THAT MY EXECUTION OF THIS DOCUMENT CONSTITUTES: an unqualified ASSUMPTION OF ALL RISKS associated with participation in this program by my minor child/ward even if arising from negligence, or gross negligence, including any compounding or aggravation of injuries caused by negligent rescue operations or procedures, of the program organizer and any persons associated therewith or participating therein, and a FULL AND FINAL RELEASE AND WAIVER OF LIABILITY of the program organizer and all persons and organizations associated with it and the program including, without limiting the generality of the foregoing, its officers, directors, officials, agents and/or employees, other participants, sponsors, advertisers, owners and/ or lessors of the premises used to conduct the program, sanctioning bodies, NASHA, medical or rescue personnel (the RELEASEES), of and from with the respect to all injury, disability, death or loss or damage to person or property whether arising from the negligence, or negligent rescue of or by the foregoing or otherwise, and an UNDERSTANDING NOT TO SUE the RELEASEES for any loss, injury, costs or damages of any form or type, how so ever caused or arising, and whether directly or indirectly from the participation of my minor child/ward in the program, and an AGREEMENT TO INDEMNIFY, and to SAVE and HOLD HARMLESS the RELEASEES, and each of them, from any litigation expense, legal fees, liability, damage, award or cost, of any form or type whatsoever, they may incur due to any claim made against them or any one of them whether the claim is based on the negligence or the gross negligence of the RELEASEES or otherwise. COMMUNICABLE DISEASES INCLUDING COVID-19 ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT In consideration of being allowed to participate on behalf of Weekend Hockey Tournament Inc athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS (insert name of sports organization) their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law. TYPE Name on this field as signature: Send me information from NASHA Enter the code you see on the left FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION) This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. Furthermore, my child/ward understands and accepts these risks and responsibilities. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE to the fullest extent provided by law. I HAVE READ THIS DOCUMENT THOROUGHLY. I UNDERSTAND THAT THE RELEASEES ARE RELYING UPON MY WARRANTIES, ASSUMPTIONS, WAIVER AND RELEASE, UNDERTAKINGS AND AGREEMENTS WHEN ACCEPTING MY MINOR CHILD'S/WARD'S / COACH / INSTRUCTORS PARTICIPATION IN THIS PROGRAM. I UNDERSTAND THAT BY GIVING MY SIGNING THIS DOCUMENT I GIVE UP SUBSTANTIAL LEGAL RIGHTS I AND/ OR MY MINOR CHILD/WARD WOULD OTHERWISE HAVE. I SIGN THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT.