Welcome To The 
North American AAA Champions Cup

2011 Tournament Checklist

Please fill out and return this checklist along with your tournament application, team roster and entry fee.

Team Name & Team Contact 
Phone   Fax
Address
E-mail
Team contact while in Las Vegas
Cell
At which hotel will your team be staying 
Number of rooms booked 

"Canadian Teams" - Remember Parents, Please notify your Provincial Health care that you are going to the United States for a hockey tournament / Vacation. There may be a small fee to extend your health care into the United States so you and your family are covered by Health Insurance. Better safe then sorry.

Have you included the following?

Team Roster  Y N  
Team Logo Y N  - Team Logo and Roster deadline for tournament program is June 1, 2011
Tournament Application Y N  
First Aid Kit?  Y N ( All Teams Must Have a First Aid Kit )

 Name of Team Certified First Aider

WAIVER: In consideration of being allowed to participate in the North American AAA Champions Cup hockey tournament, related events, and activities, the undersigned acknowledges and agrees, on behalf of the attending team that the North American AAA Champions Cup will not be held responsible for any accident, injury, or loss however caused and hereby releases and holds harmless the North American AAA Champions Cup, their officers, directors, officials, coaches, agents, and/or employees, other participants, arena officials and owners, sponsors, and advertisers, with respect to any and all injury, disability, or loss to person or property, whether caused by the negligence of the releases or otherwise.

The Team Representative that sign's/prints his / her name on this Checklist Form / Waiver Page also acknowledges & states that the team he represents carries fully paid up "VALID LIABILITY INSURANCE" ( minimum of $2,000,000 ) and that the Team ( Players, Coaches, Manager, Trainer etc ) also carry  adequate "MEDICAL & ACCIDENT INSURANCE.
 

Signed

Title