2024 CCM Chi-Town Shuffle

Date
Apr 19, 2024 / Apr 21, 2024
Location
US Illinois
Event Coordinator
Chris Kaspar
Client
Jack Ormson
Registration#
26387
Registration Date
Jan 12, 2024
Team Name
HC of STL - 2016 Elite 2016
Manager
Nathan Hirsch
Coach
Nathan Hirsch

WAIVER AND RELEASE OF LIABILITY AGREEMENT 

In consideration of being allowed to participate in any way in the ice hockey program, games, tournaments and/or related events and activities (collectively, the “Event”) organized by 200x85, LLC, 200x85 Holdings, LLC or 200x85 Holdings, Inc. (collectively, “200x85”), I ACKNOWLEDGE, UNDERSTAND AND AGREE THAT: 

1. The risk of injury from participating in the activities involved in this Event is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 

2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, of my participation in the Event, even if arising from the negligent act or omission of the RELEASEES (as defined below) or others, and assume full responsibility and liability for my participation in the Event and for any loss, damage or injury of any nature that I may sustain arising out of my participation; These risks and dangers further include risks of sickness arising from any and all communicable disease, germs, bacteria, viruses or infections, including without limitation the virus responsible for COVID-19, whether now known or later discovered; and, 

3. I willingly agree to comply with the stated and customary terms and conditions for participation in the Event. If, however, I observe any unusual significant hazard during my presence or participation in the Event, I will remove myself from participation, and shall 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, DO HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS 200 x 85 and the owner of the premises used to conduct the Event, and their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors and advertisers of the Event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, OR LOSS OR DAMAGE TO PERSON OR PROPERTY, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law; and, 

5. I hereby agree that 200x85 may use film, voice or photographic records of my participation in the activities for its promotional and/or commercial purposes. This includes (but is not limited to) social, media, and other means of marketing via photography, video, live stream, etc. I also agree to be included in 200x85 Communications for email and text contact and inclusion in their email and text marketing efforts (of which I can unsubscribe at any time). I have read this release and understand that I am giving up substantial rights by agreeing to it. I have signed freely and voluntarily, without inducement or assurance of any nature. I understand that it will apply for each day I am on and/or engaged in any activity by 200x85. I intend this waiver to be a complete and unconditional release of all liability to the greatest extent allowed by law; and, 

6. To the extent that the Event is a USA Hockey or AAU Hockey sanctioned event, I confirm I am a member in good standing of such organization, as applicable. 

I HAVE READ THIS WAIVER AND RELEASE OF LIABILITY, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I AM AGREEING TO GIVE UP AND SURRENDER SUBSTANTIAL RIGHTS, WITHOUT RESERVATION, FREELY, VOLUNTARILY AND WITHOUT ANY INDUCEMENT. 

If signing on behalf of a minor, I attest that I am the parent or legal guardian of the minor named below. I have the legal right to consent to, and I hereby consent and agree to the terms and conditions of this Waiver and Release of Liability.  

Complete Waiver Form

For participants under 20, a parent or guardian must provide their information.

* Required

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