Last Name _______________________ First ______________________ Email ______________________

Parents Name(s) _________________________________________________________________

Address __________________________________ City ___________________ State ____ ZIP ________

Home Phone ______________________ Work _____________________ Mobile ____________________

Emergency Contact(s) ________________________________ Phone ______________________________

Date of Birth ____/____/________ Age ________ Gender: Male / Female

Position: Forward / Defense / Goalie Shoots: Left / Right Catches: Left / Right Level A / AA / AAA

Where would you like to improve? __________________________________________________________

Please Check All Camps Attending:

____July 7th-11th Center Ice of Dupage-- ____August 11th-15th Center Ice of Dupage

BY SIGNING THIS WAIVER AND RELEASE, PARTICIPANT AND PARTICIPANT'S PARENT(S)/LEGAL GUARDIAN(S) AFFIRM HAVING READ IT
It is the purpose of this agreement to exempt, waive and relieve releasees from liability for personal injury, property damage, and wrongful death, including injury and damage caused by negligence, including the negligence, if any, of releasees. "Releasees" include Sean Berens, the Edge Ice Arenas and all employees, agents, instructors, coaches, and affiliated entities/companies in any way involved or associated with Sean Berens Hockey, Sean Berens' Tricks of the Trade Hockey Development Camps and/or the Edge Ice Arenas. For and in consideration of participant being allowed to participate in Sean Berens' Tricks of the Trade Development Camps, participant (and the parent(s) or legal guardian(s) of participant, if applicable) waive, release and relinquish any and all claims for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring to participant, arising out of participation in Sean Berens' Tricks of the Trade Development Camps and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue. By this agreement, any such claims, rights, and causes of action that participant and participant's parent(s)/legal guardian(s) may have are hereby waived, released and relinquished, and participant and participant's parent(s)/legal guardian(s) does(do) so on behalf of participant and participant's parent(s)/legal guardian(s)' heirs, executors, administrators and assigns. Participant and participant's parent(s)/legal guardian(s) acknowledge, understand and assume all risks relating to ice hockey and related activities and understand that ice hockey and related activities involve risks to participant's person including bodily injury, partial or total disability, paralysis and death, and damages which may arise therefrom and that participant and participant's parent(s)/legal guardian(s) have full knowledge of said risks. These risks and dangers may be caused by the negligence of the participant or the negligence of others, including the "releasees" identified above. Participant and participant's parent(s)/legal guardian(s) further acknowledge that there may be risks and dangers not known to participant and participant's parent(s)/legal guardian(s) or not reasonably foreseeable at this time. Participant and participant's parent(s)/guardian(s) acknowledge, understand and agree that all of the risks and dangers described throughout this agreement, including those caused by the negligence of participant and/or others, are included within the waiver, release and relinquishment described herein. Participant and participant's parent(s)/legal guardian(s) acknowledge, understand and assume the risks, if any, arising from Sean Berens' Tricks of the Trade Development Camps and related activities and/or the conditions and use of The Edge Ice Arenas and related premises and acknowledge and understand that included within the scope of this waiver and release is any cause of action (including any cause of action based on negligence) arising from the performance, or failure to perform, maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said rinks, for negligent selection of certain releasees, or negligent supervision or instruction by releasees. Participant and participant's parent(s)/legal guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers of ice hockey and related activities. ARBITRATION: In consideration of allowing participant to participate in Sean Berens' Tricks of the Trade Development Camps, participant and participant's parent(s)/legal guardian(s) hereby agree to submit to binding arbitration any and all claims which participant and participant's parent(s)/legal guardian(s) believe exist against the releasees. The arbitration shall be conducted pursuant to the rules of the American Arbitration Association. The arbitrators shall apply the Federal Rules of Evidence to all proceedings. Arbitration shall be commenced within one (1) year from the date on which any alleged claim first arose. Further, the arbitration shall be held in DuPage County, Illinois, unless otherwise mutually agreed to by all parties.

I HAVE READ, AND UNDERDSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.

___________________________________	___________________________________	____/____/________
Participant Signature	Age	Date Sighned
___________________________________	___________________________________	____/____/________
Print Name of Participant	Parent or Guardian Signature (if Participant is under 18)	Date Sighned

Please include $80 deposit cash or check or full $330 payment to:
Tricks of the Trade
-140 Wood Street-Suite 410-Palatine-IL-60067-
-Phone 847.529.5316-Fax 847.934.3405-
Remaining balance of deposit due 1st day of camp