Ahc Web Site Consent Form

AHC WEB SITE CONSENT FORM

FOR POSTING PERSONAL INFORMATION TO THE

AHC WEBSITE AND RELEASE OF

PERSONAL INFORMATION FOR CLUB PURPOSES

Player Name: ______AHC Level:______

A: By signing this document, I/we consent to the disclosure of personal information (i.e.: name, photographs, hockey stats, awards/prizes received) about the above listed player by posting it to the web site of Annunciation Hockey Club at www.ahchockey.com .I/we are aware that by giving this consent, I/we are permitting personal information about my/our child to be posted to the Annunciation Hockey Club website, which can be viewed by anyone who accesses to the Annunciation Hockey Club web site and that if consent is withheld, this posting would not occur. Note: AHC DOES NOT post player’s personal information such as phone numbers, email, address, etc to our site.

B: Also, I/we consent that any information given to the Registrar can be distributed to the director of the division which my/our child plays and the coach of the team to which she has been assigned. Further that the coach may disclose my/our child’s phone number and e-mail to the other parents on the team in the form of a team contact list.

I/we further understand that this consent is valid for one year and may be withdrawn by me/us at any time upon written notice. In the event that consent is withdrawn, I/we understand that the information about our child will be removed from the website and team lists.

Please check the box(es) which applies

□ I/we consent to the website release (see A above)

□I/we consent to the personal information release (see B above)

I/we have given this consent voluntarily.

Signed at______on ______

Place of Signature / Date

______

Signature

* For players under 18 years of age: signature of parent (or legal guardian)

* Note: Only persons having lawful custody of the player may sign this consent form as parent or legal guardian. If both parents have lawful custody, one or both may sign.