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Online Member Enrollment Form & Waiver (for calendar year 2019)
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Indicates required field
Member's Name
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First
Last
Authorized Signer (if different than Member)
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First
Last
Relationship to Member
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N/A
Parent
Guardian
Neither
Member's Birthday
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This is required by GAA for registration and for youth to determine the group level (U8, U10, U12, etc.)
Address
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Line 1
Line 2
City
State
Zip Code
Country
Member's Country, State and County of Origin (Example USA, Illinois, Kane or Ireland, Clare)
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The GAA requires this information to determine the appropriate grade each member should be assigned to. As an example, adults may be placed in Jr. C or Jr. B).
Phone Number
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Email
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Health Concerns (N/A if not applicable or you choose not to reveal)
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Please list any known health issues the club should be aware of in case you are injured during play. This may include allergies, heart conditions or medications you are taking. Disclosing this information is at your discretion.
The member does / does not want to register as an NHC member with the USGAA. This decision has no bearing on local and regional matches, only on USGAA qualification and playoff matches. Selecting "Does" gives NHC permission to provide required data to the USGAA.
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Does (if selected, registrant can but is not required to compete in USGAA qualification and playoff competitions)
Does Not (if selected, registrant cannot play in USGAA qualification and playoff competitions)
Inter-County or Club-to-Club Transfers
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I am already registered with Naperville and intend to stay with Naperville.
This is my first registration with a GAA club.
I was last registered with a club in Ireland and need to do an Inter-County Transfer to Naperville
I was last registered with a US-based GAA club and need to do a club-to-club transfer to Naperville
I am registered with another team and do NOT want to transfer to Naperville
I don't know what you are talking about.
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This registration is for (choose all applicable)
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2019 Outdoor Season
Check all that apply.
The member wants to play in (choose one):
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Youth Programs
Local League Games Only (Including Indoor)
Local League Games and Regional Games (some travel ok)
Local, Regional and the 2018 USGAA Championships which would require travel to Philadelphia, PA over Labor Day Weekend at your own expense. The team may or may not participate in the 2018 USGAA Championships depending on how many players can commit by May 30.
If registering with us for USGAA; provide the last four digits of your ID, ID Type and State/Country of Issuance. If not, put "N/A"
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Please provide the last for digits of your ID, State (USA) or Country of Issuance (non USA) and Type (Driver's License or Passport). Otherwise put "N/A"
Self Assmt - Currently the member is a (choose one) level hurler:
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Entry Level (Jr. C - Hurling, Jr. - Camogie)
Junior B
Junior A
Intermediate
Senior
Highest Level of Play - The member has played on a (choose one) level team.
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Never Played Before 2019
Junior (Camogie)
Jr. C (Hurling)
Jr. B (Hurling)
Jr. A (Hurling)
Intermediate (Hurling or Camogie)
Senior Club (Hurling or Camogie)
County (Hurling or Camogie)
Name of Club Most Recently Registered With (N/A if not applicable):
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If you want to play with the club in the NACB finals, we may have to get a transfer from your last club of registration.
The member started hurling in about (enter year you began hurling)
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The last year the member played hurling was (enter year)
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Yes or No: Is it ok to put the member's profile on the Player Profile page of this website?
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Yes
No
Release & Liability Waiver
In consideration of being allowed to participate in any way in the indoor and/or outdoor hurling, camogie or gaelic football athletic programs (the “Activities”) with the Naperville Hurling Club, and other related events and activities, the undersigned acknowledges, appreciates, and agrees that:
1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and cannot be eliminated entirely; and,
2) I understand that specific risks vary depending on the level and nature of the activity, and can range from minor personal injuries such as scratches, bruises and sprains, to major injuries such as eye or brain injuries, back and joint injuries, or catastrophic injuries including paralysis or death. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
3) To the best of my knowledge, I am not aware of any physical disability or health-related reasons that would preclude or restrict my participation in the Activities.
4) I have sufficient health and/or disability insurance coverage to provide for and pay any medical expenses that may directly or indirectly result from my participation in the Activities and competitors. I understand that the Naperville Hurling Club does not take responsibility for the payment of any such medical expenses.
5) 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 of the nearest official immediately; and,
6) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Naperville Hurling Club and its officers, board members, managers, coaches, agents and representatives, the North American County Board of the Gaelic Athletic Association, its divisions, member clubs and organizations, and individual members and representatives; their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
7) I, for myself and on behalf of those for whom I am signing as parent or guardian, release the Naperville Hurling Club to use images and audio that is captured before, during or after a club event, for use in marketing of the club and Gaelic Games.
8) I understand that this agreement is intended to be as broad and inclusive as is permitted under Illinois law, and that if any portion hereof is held invalid, it is agreed that the remaining terms shall continue in full legal force and effect.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARTICIPANTS OF MINORITY AGE
(UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless 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, to the fullest extent permitted by law.
By selecting "I Agree" below, you are accepting the terms and conditions of this Release & Liability Waiver.
Acceptance of Release and Liability Waiver
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I Agree
I Do Not Agree
Submit
