LACROSSE CLUB

2010-2011 Waiver

Player Name: _________________________

Team: ______________________________

Waiver and Release

Contract Agreement:

I fully understand that by signing this commitment form and paying a registration fee to the above mentioned Team Evolution Lacrosse program, my child is committed to this program from ________ through the conclusion of the Lacrosse season as determined for the 2011 season by Team Evolution. It is also my responsibility to know the rules
governing Lacrosse, which I will obtain from this program. The commitment fee will be applied to the total fee for the upcoming season and is non-refundable.

Release of Liability/Acknowledgment of Risk:
In consideration of being allowed to participate as a student, player, instructor, coach, counselor, assistant, parent or volunteer (herein called “participant”) in any Team Evolution Lacrosse (herein called “the Program”) activity, the undersigned
acknowledges and agrees that: (1) The participation in or observation of Lacrosse sporting activities have inherent physical risks that may result in serious injury including permanent paralysis or death. (2) I knowingly and freely assume all such risks, both known and unknown, and assume full responsibility for my child’s participation. (3) I understand and agree that neither the Program nor any of its officers, directors, shareholders, employees, agents, coaches, referees, tournament facilities
or employees of these facilities used by the Program shall be responsible or held liable for any accidents, injury (including paralysis and/or death), loss of equipment or any other costs, expenses, damages or losses in connection with such participation. (4) The participant is responsible for any and all medical costs for any injuries arising from or around the Program activities. (5) I hereby represent to the Program that my child has no known medical condition that restricts or prohibits participation in Lacrosse or any related activity. Nor does participant have any know medical condition which puts
him or her at greater risk of injury or death resulting from any risks associated with participating in Program activities, whether such risks are known or unknown to parent or participant. (6) In the event of injury or illness, I give permission for the Program or its designee to provide, or make arrangements for the provisions of, emergency first aid. (7) The Program reserves the right to terminate participation in Program activities based upon inappropriate behavior by participant or parent without refund. Participant shall act in a mature and responsible manner. Any behavior that the Program deems to endanger the safety of other persons or property, or jeopardize the Program’s ability to conduct its business, will result in the participant’s immediate expulsion. Participant may also be expelled from participation in Program activities for financial delinquency, failure to abide by all Program and Lacrosse Facilities rules and directives and/or falsification of registration information.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

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TEAM EVOLUTION WAIVER AND RELEASE FORM