Registration

* Required

First Name:*
Last Name:*
Phone:
Phone 2:
Email:*
Address:*
City:*
State:*
Zip:*

Age Group:

Preferred Position:*

How many years have you played hockey?*

What is the highest level of hockey that you have played?*

When would you prefer to play?

Jersey Size:

Comments:


Individual Release/Waiver Form By clicking submit, in consideration of playing hockey in Dayton Recreational Adult Hockey Association (LICENSOR) do hereby release and waive said licensor, it’s employees, on/off-ice officials, and administrators from any and all liability associated with my participation in any activity in Dayton Recreational Adult Hockey Association. This waiver and release extends to all heirs, assigns or guardians for myself or action in my behalf. I realize the inherit dangers associated with playing ice hockey. I am in good health and have no physical condition that would prevent or restrict me from any of these activities or games. I have also been informed that wearing full facial protection in the form of a mask is strongly recommended. I additionally certify that I am age 18 or older. I have read and understand the foregoing release.