Application for Financial Assistance (Lakefield Minor Hockey)

I hereby certify, that the information provided on this application is true and accurate. 
By agreeing, I make my application for financial assistance for my child/children/dependant to receive assistance, if possible, from the LDMHA. 

In consideration of the right and opportunity to receive assistance from LDMHA, the undersigned (on behalf of the participant) completely release and discharge and shall hold harmless LDMHA against and from any and all claims and demand of any nature whatsoever, for damages and injuries but not limited to any claims from participating in hockey.  The undersigned acknowledges that the participant and their families have chosen to participate on their own free will.  This release shall further apply to all unsuspected, unknown, unanticipated and undisclosed claims, demands, liabilities, actions or causes of action, in law, equity or otherwise.

By submitting this application, I am requesting and agreeing that without funding this child would otherwise not be able to play hockey.

A copy of the most recent tax benefit may be requested for applicants. 

I have read and understand the terms stated above and agree to all aspects of this release.