I am enrolled in a medical insurance program with

is covered. I am aware that the Girls Iceless Hockey Association (GIHA) is not enrolled in a medical plan. I consent to the foregoing and grant permission for my child to participate in the GIHA. In consideration of participation in the activities of the GIHA, I do hereby fully release, indemnify, discharge, and save whole and harmless the GIHA, an Illinois non-profit corp., the Officers and Board of Directors, Coaches and other players, and their successors, from any and all liability for damages or claim for damages, causes of action, claims, demands, costs, expenses, and compensation of any nature whatsoever, and any and all known and unknown personal injuries, sickness, illness or disorder, which I may now or hereafter have (as parent and/or guardian of my minor child, and also all claims of action for damages which the said minor child has or may hereafter have) arising out of or connected with participation in any activities whatsoever of the said GIHA. I further state that I have carefully read the foregoing application including the LIABILITY WAIVER and RELEASE and SPECTATOR AND PARENT CODE OF CONDUCT and know the contents thereof and I sign the same as my own free act and deed. Directors of the GIHA reserve the right to suspend or expel players, parents, spectators and/or coaches for disciplinary actions without refund.