Membership Online Registration

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Personal Information

Personal Information

Before filling this application form, please prepare your headshot photograph file. FHEI Membership (Junior): Rp150.000,-

Name

Name *

YYYY-MM-DD

(cm)

(kg)

ex. +62 8123456789

Ice Hockey Skill Information

Ice Hockey Skill Information

(years)

Emergency Contact

Emergency Contact

Name

Name *

ex. +62 8123456789

FHEI's Liability Waiver

FHEI's Liability Waiver

I acknowledge that by accepting this Membership Application, I will become a member of the FEDERASI HOKI ES INDONESIA (FHEI). As a member, I acknowledge that I will be subject to the terms of this Membership Application, FHEI’s rules, bylaws and FHEI’s Constitution. FHEI reserves the right to change the terms of this Membership Application and its rules at any time, and also reserves the right to waive or modify any of these terms as they apply to a specific member without affecting the application of these terms to all other members. Changes will be effective when made, unless specified otherwise. Copies of changes made to this Membership Application and its rules, shall be posted to my address that has been given to the FHEI. I will update the FHEI should there be any changes to my personal particulars including, but not limited to, my address. As a member, I also understand that should any claim be made against the FHEI, I will share liability with other members equally. In consideration of being allowed to participate in any way in events sanctioned by the Federasi Hoki Es Indonesia related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. The risk of injury from the activities in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risks, the risk of serious injury does exist; and 2. I expressly agree that I am voluntarily participating in these activities. 3. I KNOWLINGLY and FREELY ASSUME ALL SUCH RISKS, both known and unknown EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my participation; and 4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention to the nearest official immediately; and 5. By accepting the terms of this agreement, on behalf of myself, my heirs, assigns, insurance companies, executors and administrators, I acknowledge that I do hereby waive, release and forever discharge FHEI and its subsidiaries, affiliates, officers, directors, agents, and employees (collectively known as “Releasees”), and all others from any and all responsibilities or liability from injuries or damages resulting from or connected with your participation in any of the FHEI’s programs whether arising from the negligence of the releasees or otherwise. 6. I warrant that I am physically fit and able to engage in the activities of FHEI.

Visitors and Damages; Indemnification

  1. I agree not to bring visitors, who are not members of FHEI, onto the premises of FHEI or allow any visitor, who is not a member of FHEI, to use the facilities of FHEI, UNLESS with the PRIOR APPROVAL of FHEI.
  2. I also agree that any visitor brought onto the premises will not be allowed to engage in and/or participate in any ice-hockey activities and/or games, including training sessions, if prior approval of the FHEI has not been obtained.
  3. I agree to indemnify the Releasees, for any claim or demand, including legal costs, made by any visitor I bring to the premises of FHEI, due to or arising out of any violation of any law or the rights of the visitor that occurs in connection with the visitor’s use of the premises, including but not limited to the Negligence of the Releasees.

Basic Competency Level

  1. I agree that I must possess basic ice hockey skills and knowledge of the applicable rules of the game before I am allowed to play the game. In order to demonstrate the mentioned skills and knowledge, I must pass any theoretical or practical test required by the FHEI, including but not limited to demonstrating my knowledge and skills before an officer authorized by or representing the FHEI. Only after I have demonstrated my skills and knowledge to the desired level will I be allowed to engage in and/or participate in any ice-hockey activities and/or games, including training sessions.
  2. Should the situation arise that I do not have adequate skills and knowledge as assessed by the FHEI, I will be directed by the FHEI to join the necessary instructional classes in order to be certified as fit and competent to engage in and/or participate in any ice-hockey activities.
  3. This Membership Application shall be governed by and construed in accordance with the laws of the Indonesia, excluding its conflicts of law rules. I agree that the exclusive jurisdiction for any claim or action arising out of or relating to the Membership Application shall be filed only in the Courts of Indonesia and I further agree and submit to the exercise of personal jurisdiction of such courts for the purpose of litigating any such claim or action.

I HAVE READ THE RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY ACCEPTING IT, AND ACCEPT IT FREELY AND VOLUNTARY WITHOUT ANY INDUCEMENT.

FOR PARTICIPANTS OR MINORITY AGE (UNDER AGE 18 AT TIME OF REGISTRATION). This is to certify that I, as parent/guardian with legal responsibility for this applicant, acknowledge the above clauses and do consent and agree to the applicant’s release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.

DISCLAIMER
Property Responsibility:
Any damage to the ice skating rink, the surrounding Plexiglas barrier, the rink support area, its interior and furnishings, the rink surfacing equipment and injury to other participants participating therein by way of negligence or willful intent will be the responsibility of each individual applicant.

Security of Property:
FHEI will not be responsible for the loss or damage of the applicant’s valuables or property before, during or after the rented ice time.

Loss, Injury and Accidents:
It is hereby understood and agreed that the FHEI shall not have any liability howsoever arising in respect of any bodily injury to any person, or for any accident to or loss of property of any person while participating in or observing any FHEI endorsed activities. Use of the ice surface is entirely at the risk of the applicant. Accidents occurring on or off the ice will be the responsibility of the applicant and it is therefore suggested the applicant consider his own insurance coverage. This application constitutes a contract between the applicant, and the FHEI and a release of liability to FHEI. Each applicant is bound by the terms herein.

The player agrees that FHEI or NIHL can release any information about the player to their sponsors, the Indonesia Sports Council, and/or the International Ice Hockey Federation.

Bank Transfer Detail

Bank Transfer Detail

Bank: MANDIRI

Account Number: 164-00311-22015

Beneficiary Name: FEDERASI HOKI ES INDONESIA

A scanned copy or photo of the transfer receipt must be emailed to administration@fhei.org to confirm receipt.

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