2017 Great Western Indoor Lacrosse League Registration

Please fill out the following forms leaving no areas blank.
* All fields are Required

    Player Information

     
     
     
     
     
     
     
     
    Please put N/A if player does not have an Email of his own
     
     
     
     
     
     

    Great Western Indoor League Player Release Form

    I understand that:
    1) My child is in good physical condition and has had a physical examination in the last 365 days;
    2) I am hereby waiving and releasing Great Western Lacrosse, the Great Western Lacrosse indoor lacrosse League, its Director and all staff, the Poway Sportsplex, and any sponsors, of any and all liability for injuries incurred by my child while playing in the league even if arising from negligence;
    3) I understand that this League is run at a facility with artificial grass and that a $3.00 fee is charged by the facility upon entering, for any person 16 years of age or older;
    4) I am aware that this league is a "play at your own risk" league and that I must have primary medical insurance coverage that blankets my child, the participant;
    5) I am aware that this is a "no hit" league, I have discussed this with the participant. I am also aware that any disregard of the rules will result in expulsion from the league without refund and that the Director, the Coaches and/or the Referee have the irreversible right and judgment to expel any player;
    6) I am aware that all the coaches work for Great Western and not for the individual teams;
    7) I understand that the Great Western Indoor Lacrosse League does not allow disrespect or negativity from the fans/parents watching the games, either towards opponents, the referees or other fans/parents;
    8) I understand that there will be no Athletic Trainer on duty during games.

    In the event that my child is injured and I am unable to give parental consent, I hereby authorize the Physician/Hospital Staff at any Hospital to provide care to include diagnostic procedures and medical treatment as necessary to my child, who is a minor. By signing below, I am entering into a contract willfully and without coercion. I am aware that the League fee of $200.00 (and Practice Fee of $100) is non-refundable for any reason after 9 / 16 / 2017, not even for an injury.
     

     

    Great Western Indoor League Player Waiver & Release of Liability Form

    Great Western Lacrosse Programs AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY FORM READ CAREFULLY BEFORE SIGNING In consideration of being allowed to participate in any way in a Great Western Lacrosse athletic sports programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that: 1. The risk of injury from activities involved in this program is significant, including the potential for permanent injury and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; and, 2. 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. 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, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Great Western Lacrosse Company, its Director, 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 NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 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 inducement. PARENT’S SIGNATURE REQUIRED FOR ALL PARTICIPANTS { ESPECIALLY UNDER THE AGE OF 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 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.
     
     

    US Lacrosse Participant Waiver & Release of Liability

    For participation in the Great Western Indoor Lacrosse League. Instructions:
    1.) each Player should read the statement below before completing and signing this Waiver & Release Form.
    2.) Parents / Guardians should read the statement below before completing this Waiver & Release Form.

    Agreement: In consideration of my membership in US Lacrosse and of my participation in the sponsored activities of the Great Western Indoor Lacrosse League, I acknowledge, agree to and understand that:
    1.) Readiness to Compete: Voluntary and of my own free will, I elect to participate in the Great Western Indoor Lacrosse League. I will only participate in those US lacrosse competitions and activities sponsored by Great Western Lacrosse for which I believe I am physically and psychologically prepared to compete.
    2.) Rediness to Compete: I hereby give consent to US Lacrosse and to Great Western Lacrosse, the Poway Sportsplex and the hostr organization of any US Lacrosse sponsored event to provide through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted through the course of my participation in sponsored lacrosse activities.
    3.) Waiver & Release of Liability: I am fully aware of and appreciate the risks associated with participation in a lacrosse event, including the risk of catastrophic injury, paralysis and even death, as well as other types of damages and loss. I further agree on behalf of myself, my heirs, and personal representatives, that US Lacrosse, Great Western Lacrosse, the Poway Sportsplex, the host organization, and sponsors of any US Lacrosse event, along with their coaches, volunteers, employees, agents, 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(s). My signature below is my acknowledgement that I have read and understood every provision of this Waiver and Release of Liability, and that I agree to abide by it.