West Chester - June 20-23
South Jersey - June 27-30
EMERGENCY CONTACT INFORMATION
In Consideration of my participation in YOUR NAME HERE . sponsored events and activities, ICheck this box to indicate that you have read and agree to all of the above terms & conditions
agree to the following:
1. Waiver and Release: I am fully aware of and appreciate the risks, including the risk of
catastrophic injury, paralysis, and even death, as well as other damages and losses, associated
with participation in a lacrosse event and related sports conditioning activities. I further agree
on behalf of myself, my heirs and personal representatives, that YOUR NAMES HERE along with coaches, officials, referees, volunteers, employees, agents, sponsors, officers,
and directors of these organizations, shall not be liable for any injury, loss of life or other loss
or damage occurring as a result of my participation in the event.
2. Medical Attention: I hereby give my consent to First Class Lacrosse Plus, LLC. to provide,
through a medical staff of its choice, customary medical/athletic training attention,
transportation and emergency medical services as warranted in the course of my participation
in YOUR NAME HERE sponsored or sanctioned events.
3. Readiness to Compete: I will only participate in those competitions or activities in which I
believe I am physically and psychologically prepared to participate.
As legal guardian of this participant, I herby verify by my signature below that I have read and
fully understand each of the conditions under Participant Waiver and Release section for permitting my
child to participate in any YOUR NAME HEREsponsored events and activities and I accept each
of the conditions, especially the waiver and release set forth in paragraph one.
All participants are required to be covered with insurance for accidental injury. In most instances, family
health insurance is adequate. Please indicate your family health insurance plan above.
Medical Treatment Authorization
I/We being the legal guardians of the applicant authorize First Class Lacrosse Plus LLC and its agentís
permission to request medical treatment as necessary to insure the well being of our dependent.