Please
print out this form and mail it to:
The
Northford Ice Pavilion
P.O.
Box 70
Northford, CT 0647
Questions?
Call 484-4054
Make
checks payable to "Northford Ice Rink Assoc., LLC"
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HOLD HARMLESS AND IDEMNITY AGREEMENT: To induce and hold harmless the Northford Ice Pavilion,Northford Ice Rink Assoc.,LLC,and its employees and coaches to permit participation by the named individual below in all practices,I hereby give my consent and agree to release indemnity and hold harmless the Northford Ice Pavilion,Northford Ice Rink Assoc.LLC., and its employees and coaches from any claim arising out of injury to the individual named below.
I am interested in (please check one):
_____ Snowplow Sam for Tots (Levels 1-3)
_____ Basic Skills (Levels 1-8)
_____ Freeskate Lessons
_____ Hockey Lessons
_____ Adult Lessons
_____ Private Lessons
Please fill out the information requested below:
Name: _____________________________
Age:________________________________
Date
of Birth:_______________________
Address:____________________________
City:________________________________
State:
________
Zip:______________
Phone:_______________________________
Skating
Experience:_________________