Please enable JavaScript in your browser to complete this form.Child's Name *FirstLastBirthdate (Please ensure birth year is entered correctly)GenderMaleFemaleProvincial Medical Health Number (all participants must have BC Health insurance)Parent/Guardian Name *FirstLastI would like to volunteer to help with Pond Hockey (and understand I must complete a waiver too).YesNoPhone NumberEmail Address *Please select which minor hockey association you play withWest Kelowna Minor HockeyKelowna Minor HockeyNo associationOtherPlease select your child's SKATING skill level (Participants MUST be able to skate to participate in our program)BeginnerAverageAbove AveragePlease select your child's HOCKEY skill level BeginnerAverageAbove AverageSpecial information or requests (i.e., medical, different age group, sibling grouping, etc.)PLAYER REGISTRATION - Prices below include GST (If your child is a GOALIE, choose goalie option at bottom of list, then select session time from list that populates below.) *5-7 YRS - Mondays @ 3:15pm - $450.005-7 YRS - Tuesdays @ 3:15pm - $450.005-7 YRS - Wednesdays @ 4:00pm - $450.008-10 YRS - Mondays @ 4:30pm - $450.008-10 YRS - Tuesdays @ 4:30pm - $450.008-10 YRS - Wednesdays @ 5:15pm - $450.0011-13 YRS - Tuesdays @ 5:45pm - $450.0011-13 YRS - Wednesdays @ 6:30pm - $450.00My Child is a goalie (Select day/time from the menu that populates below) - $225.00GOALIE REGISTRATION (If you register your child as a goalie, they must remain a goalie throughout all 10 games) *5-7 YRS - Mondays @ 3:15pm5-7 YRS - Tuesdays @ 3:15pm5-7 YRS - Wednesdays @ 4:00pm8-10 YRS - Mondays @ 4:30pm11-13 YRS - Tuesdays @ 5:45pm11-13 YRS - Wednesdays @ 6:30pmOFFICIAL JERSEYS REQUIRED - Please check one below (Note: Jerseys may NOT be ordered after registering) *My child does NOT have a Pond Hockey jersey - Price is for two jerseys (blue & yellow) - $50.00My child already has both (blue & yellow) official Pond Hockey jersey (PLEASE double-check to ensure jersey still fits!) - $0.00 Hockey JERSEYS If your child does NOT have our official Pond Hockey jerseys, please select a size below. Refer to the sizing chart below from jersey manufacturer. If in doubt, go with the larger size! ALL players must wear official jerseys, which are special ordered and CANNOT be returned or exchanged, so please ensure your size selection is accurate. *--- Select Choice ---Youth MYouth LYouth XLAdult SAdult MAdult LAdult XLAdult 2XL If the above sessions fill up quickly, we will add another session for that age group. If you would like to be contacted (to change or add session) if another date/time becomes available for your child's age group, please select yes below. *No, we are happy with the chosen date & timeI would like to be contacted if more sessions are addedPlease select if you would like your child to be added to a spare list for other sessions for their age group. (We will reach out on an as-needed basis if absences occur throughout the season) *Yes, add my child to the spare list for their age groupNo, my child would not like to be on the spare list**PLEASE READ CAREFULLY: We do NOT offer refunds or credits for cancellations once registered. Please ensure your child's schedule can accommodate the Pond schedule BEFORE registering. By selecting yes bellow, you understand that this registration is non-refundable and non-transferrable. *Yes, I understand.Total Amount Due (Including GST)$0.00Payment *CardName on CardBilling Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryBy checking this box you agree to the terms and conditions of our Pond Hockey Program, as outlined below *I accept these terms and conditionsI submit this waiver/usage agreement on behalf of myself, OR as the legal guardian of the minor named above (hereinafter referred to as the PARTICIPANT) who is/will be visiting or participating in an ice program or private ice rental at the WEST KELOWNA HOCKEY CENTRE (hereinafter referred to as the WKHC). IN SUBMITTING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I am the PARTICIPANT listed above or the LEGAL GUARDIAN of the child listed as the PARTICIPANT above and have read the foregoing Waiver of Liability and Usage Agreement, understand it and agree to it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least nineteen (19) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same. I hereby release, waive, discharge the West Kelowna Hockey Centre, its owners, employees and agents, successors from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of, or related to any loss, damage, liabilities, expenses, costs, illness (including COVID-19) or injury, or death, that may be sustained by any participant or guest or to any property belonging to me, while participating in such activity, while in, on or upon the premises where the activities are being conducted, regardless of whether such loss is caused by the negligence of the releasees, or otherwise and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, to the fullest extent allowed by law. As, or on behalf of the PARTICIPANT, I agree to the following facility usage conditions: • Entry is not permitted to anyone who is ill, experiencing cold, flu, RSV or COVID-19 virus symptoms. • To enter facility persons may be required to wear a mask when deemed necessary by management. • Facility may be closed at times due to • Provincial mandates. • Masks, hand-sanitizing and distancing are recommended to minimize transmission of viruses. • All participants including trainers, coaches, supervisors & anyone wishing to access dressing rooms must submitted an online waiver in advance. • No spitting at any time. • Sharing of water bottles or equipment is prohibited. No food is permitted inside dressing rooms. • Participant must maintain discipline and ensure appropriate conduct while using the facility. Vandalism, abuse of staff and volunteers and any behaviour that is disruptive to other users and employees, or is in any way inappropriate or in violation of the policies will not be tolerated and users will also be held liable for any damage to the facility or its equipment resulting from negligent use, irresponsible behaviour or violations of any of the policies outlined here by the user(s) or any individuals associated with his/her party. This policy extends to the family members, siblings and friends/associates of the participant attending the facility during, before or after, the user’(s) allotted rental period. Siblings are not permitted in the dressing room areas. Children may not be dropped off and left at the facility without an adult from their group present & must be supervised in the facility at all times. • Participant is required to wear full equipment including a CSA approved helmet at all times while on the ice & bench. • Participant is required to carry up-to-date private or government health insurance. • Groups must provide a reliable adult (19 yrs+) to be personally responsible for the group observing all policies. • Groups must provide a safety person/first aid attendant and/or supplies for group. • Participant must follow all safety protocol. • Participant must not enter the ice surface until the designated rental start time and promptly leave the ice surface at the designated rental end time. Participant must leave the ice surface during ice cleans and remain off the ice surface until after the Zamboni has left the ice and the arena gates have been closed. Water bottles and other equipment must not be left on the boards while the Zamboni is conditioning the ice. • Participant must vacate dressing rooms 20 mins following ice session. Vacate parking lot promptly. • Group Manager must inspect the premises and equipment on each occasion, before commencing use of the premises, and notify the Rink Attendant of any condition that may render the premises or equipment unsafe for use. • Participant must keep and maintain rented areas in a clean and tidy condition at all times. • Garbage and other materials brought on site by the participant are expected to be removed from the building or disposed of appropriately in a garbage can or recycling container. Failure to do so will result in an additional fee for maintenance. Equipment and other items left behind by participants are subject to disposal by WKHC staff. The WKHC is not responsible for any lost, stolen or damaged articles resulting from use of the facility and we will not be maintaining lost and found services at this time. • Personal chairs are not permitted inside the facility. • The WKHC is a clean facility. • Smoking/Vaping/Alcohol/Drugs are not permitted anywhere on the grounds and use or consumption of any is strictly prohibited at all times. Participant will be held responsible for any liability resulting from the consumption of alcohol/drugs/cigarettes/vape by any persons connected or associated with their group. The WKHC reserves the right, without notice, to refuse entry, service, eject and/or suspend temporarily or permanently, at its discretion and without compensation or reimbursement any user of the facility, for behaviour that is disrespectful, disruptive, abusive and/or poses a danger to staff, other players, officials and/or other users/customers/guests and/or poses a risk of damage to the facility and/or its equipment. Participant agrees to grant and release to the WKHC the right to use photographs, audio tapes, and/or videotapes in which I and/or my children and my guests appear in any materials such as videos, films, recordings, still photographs or articles relating to the WKHC including, but not limited to, brochures, newsletters, annual reports or any other advertising and/or promotional materials whether broadcast on television, radio or any other medium. Participant wishing to photograph, videotape or live stream inside the facility must receive written (email) approval in advance by the General Manager. WKHC Ice bookings and Program Registrations are NON-REFUNDABLE. In the event a program is significantly delayed, postponed or cancelled by the WKHC, including but not limited to facility closure, the WKHC will work with the registrant to reschedule. The WKHC reserves the right to make adjustments to program dates/times at its sole discretion without compensation. Contractees & registrants cancelling or no-showing will not receive a refund nor a credit; payment is forfeited. The WKHC is a private facility and may implement policies at its discretion. Rules relating to a pandemic may change on short notice and be in effect during the period that the WKHC determines it necessary to have in place in order to minimize the transmission of Influenza, RSV, COVID-19 viruses in our facility. These rules will be strictly enforced. Customers and their guests violating any of these rules may be subject to immediate expulsion from the facility and possible future suspension. By clicking the submit button below, I agree to the above waiver/usage agreement.Submit