Cincinnati Cyclones, ECHL Free Agent Camp
Registration Form

Remit full payment with Registration form
Make all checks payable to Dean Stork
Mail To: US Bank Arena
Attn: Dean Stork
100 Broadway
Cincinnati, OH 45202

(Please Print)
Registrants Name: ______________________________________________________________________________________________
Address: _________________________________________________________________________________________________________
_______________________________________________________________________________________________________
Phone: _________________________________________________________________________________________________________
E-mail: _________________________________________________________________________________________________________
Comments of Special Requirements: __________________________________________________________________________
____________________________________________________________________________________________________________________
Are you at least 20 years of age? Yes: c No: c

Hotel Registration: Single (2 nights - $130) c Roommate (2 nights - $80) c

(Please Attach Your Hockey Resume with References To This Form)

Consent Waiver:

In CONSIDERATION of being permitted to participate in any way in The Cincinnati Cyclones Free Agent Camp, I:

1. ACKNOWLEDGE, agree, and represent that I understand the nature of such activities and that I am qualified, in good health, and in proper physical condition to participate in such an activity. I further agree and warrant that if at any time I believe conditions to be unsafe, I will immediately discontinue further participation in the activity.

2. FULLY UNDERSTAND THAT: (a) The Cincinnati Cyclones Free Agent Camp involves risks and dangers of serious bodily injury, including permanent disability, paralysis, and death (“RISKS”); (b) these RISKS and dangers may be caused by my own actions or the inaction’s of others participating in the Activity, the condition in which the Activity takes place, or THE NEGLIGENCE OF THE “RELEASES” NAMED BELOW; (c)there may be OHTHER RISKS AND SOCIAL AND ECONOMIC LOSSES either not known to me or not readily foreseeable at this time; and I FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES I incur as a result of my participation in the activity.

3. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE The Cincinnati Cyclones, their respective administrators, directors, agents, officers, members, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessees of premises on which Activity takes place, FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON MY ACCOUNT CAUSED OR ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS; AND I FURTHER AGREE that if, despite this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, I or anyone on my behalf, makes a claim against any of the Releasees, from any litigation expenses, attorney fees, loss, liability, damage, or cost which may incur as the result of such claim.

I HAVE READ THIS AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND HAVE SIGHED IT FREELY AND WITHOUT ANY INDUCEMENT OR ASSURANCE OF ANY NATURE AND INTEND IT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATES EXTENT ALLOWED BY THE LAW AND AGREE THAT IF ANY PORTIONOF THIS AGREEMENT IS HELD TO BE INVALID, THE BALANCE, NOTWITHSTANDING, SHALL CONTINUE IN FULL FORCE AND EFFECT.

PRINTED NAME OF PARTICIPANT: ________________________________________________________

PARTICIPANTS SIGNATURE: _______________________________________________________________