Lions Cup Pond Hockey Waiver & Registration – 2016

Lions Cup Pond Hockey Tournament

February 6th, 2016

This is an invitation to sign up for the Westport Lions Pond Hockey Tournament being held at the Lions Beach on February 6th, 2016. The cost of entering a team in the tournament is $150.  If a person wants to play, but cannot get a team together then he/she pays $25 and we will put you on an appropriate team.  If Mother Nature does not co-operate then a full refund will be given. Each team is guaranteed three games. Each game will be 30 minutes straight time. Please make your cheque payable to Westport Lions Club and send it to:

Westport Lions Club

Box 428

Westport, ON

K0G 1X0

A full set of rules will be published on Westport Lions website: or Westport Lions on Facebook. If you have any questions please call Bob Reddick at 613-273-3499, or email at

How to sign up:

  1. Determine your team captain.
  2. Have the team captain register and provide team information.
  3. Make out cheque for the appropriate amount payable to Westport Lions Club. Send cheque to Bob Reddick, 60 Maple Grove Lane, Westport, ON KOG 1X0
  4. Email Registration Form ( or mail it to the above address.       You are not registered until we receive the correct amount of money.
  5. To guarantee your spot in the tournament get your cheque to Bob Reddick ASAP. Don’t be disappointed.
  6. The Waiver & Rules sheet must be signed before the first game.
  7. Schedule and further details will be sent to the team captain.

Lions Cup Pond Hockey Waiver & Registration

February 6th 2016


Please accept the waiver.

IN CONSIDERATION FOR my participation in the Lions Cup Pond Hockey Tournament for Westport Lions Club:

I hereby willingly acknowledge and accept that playing pond hockey is hazardous and that hazards exist both on and off the playing surface at Westport Lions Beach;

I hereby agree that this activity is, and shall be, at my own risk and I, for myself and on behalf of my issue, estate, beneficiaries, successors, executors and any person claiming pursuant to the Family Law Act or through me, hereby release, forever discharge and save harmless WESTPORT LIONS CLUB AND ITS MEMBERS, any sanctioning bodies, sponsoring companies, participants, entrants, etc. connected with this event from and against any and all actions, claims, costs and expenses arising out of my participation in Lions Cup Pond Hockey Tournament for Westport Lions Club, including without limitation, any physical injuries, or for loss or damage to my property.

I accept this waiver & I am knowledgeable and understand the tournament rules.

Acceptance Team Members (please print) Signature
Team Name
Team Captain
Team Captain’s Email Address
Team Captain’s Telephone Number

Please check division

Men’s or Mixed Division 19-34 ____ 35-50 ____ 50+ ____
Women’s Division 19+ ____

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