Instructions:
Agreement: In consideration of my membership in US Lacrosse and of my participation in the sponsored activities of Houston Inside-Out Lacrosse Program, I acknowledge, agree to and understand that:
1.) Readiness To Compete: Voluntary and of my own free will, I elect to participate as a member of
Houston Inside-Out Lacrosse Program. I will only participate in those US Lacrosse competitions and activities sponsored by Houston Inside-Out Lacrosse program for which I believe I am physically and psychologically prepared to compete.
2.) Readiness To Compete: I hereby give my consent to US Lacrosse and to Houston Inside-Out Lacrosse, Kicks Soccer Facility, and the host 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, Houston Inside-Out Lacrosse, Kicks Soccer Facility, the host organization, and )sponsors of any US Lacrosse event, along with their coaches, volunteers, employees, agents, officers and rectors of these organizations, shall not be liable for any injury, loss of life or other loss or damage occurring ; 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.
Print Players Name.
Players Signature:
Date:
US Lacrosse Number:
Exp. Date:
Street Address:
City /Zip:
Parents Name:
Parents Sig.
Date:
By signing below, I am entering into a contract willfully and without coercion. I am aware that the fee is non-refundable for any reason . Not even for an injury.
Parent's Signature