St. Charles Floor Hockey League - (Wentzville, MO)

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Player Registration (Wednesday FALL 2024)

PLAYER INFORMATION

* First Name:

* Last Name:

Gender:

* Street:

* City:

* State:

* Zip Code:

* Phone Number:

* Birthdate:

* Parent, Guardian or Adult E-mail:

TEAM REQUEST

* Do you need a shirt?:

No, I already have one

Yes, I will pay for one ($20)

* Team Name:

* Jersey Number Request:

*If you do not need a shirt because you will be using the same shirt, please put down the name, number, and size of your current shirt so we can keep your stats correctly on the website.

* Back of Jersey Name Request (15 letter max):

* Shirt Size:

If there are any other players that registered as FREE AGENTS that you want to make sure you can team with, name in this box:

WAIVER INFORMATION

I recognize that there is an element of risk in playing in the STCFHL at O'Fallon Christian Church. I hereby release and agree to hold harmless O'Fallon Christian Church, its employees, agents, officers, directors and all volunteers from any and all liability, loss or damage, actions, claims and demands which now have or which may hereafter arise from my participation in the routine activities of the STCFHL. This release is intended to be binding upon my heirs, executors or personal representatives. Should any injury occur to me during participation in said program, I authorize O'Fallon Christian Church to arrange for or to provide emergency medical treatment and to arrange for or provide transportation to the nearest qualified medical facility. I also understand that O'Fallon Christian Church does not carry medical insurance for the members and it is my responsibility to pay all bills associated with such action.

I also agree that I will not hold the STCFHL, LLC responsible for any injury that I occur in this league. And medical bills that I receive will be covered by me.

I agree with the above *

If registrant is under 18, I, as the legal guardian, agree to terms listed above for them

Name of legal guardian:

* indicates required fields