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Registration Form

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* First Name:
* Last Name:
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Consent / Waiver lacroSSe by 3 INC. PARTICIPANT WAIVER & RELEASE Players WILL NOT Be Allowed To Play Without Signed Permission In consideration of my participation in lacroSSe by 3 INC. sponsored events and activities, I agree to the following: 1. 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 lacroSSe by 3 INC., along with coaches, 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. I indemnify and hold harmless, lacroSSe by 3 INC., any individual working as an officer, coach, athletic trainer or official or in any capacity for this organization, for any and all injuries, damages, causes of actions or claims for personal injuries or property damage, arising from my child's participation in this program, or any leagues, teams or tournaments associated with lacroSSe by 3 INC.. I understand my daughter’s participation includes possible exposure to COVID-19. 3. I hereby give my consent to lacroSSe by 3 INC. 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 lacroSSe by 3 INC. sponsored or sanctioned events. 4. I will only participate in those competitions or activities in which I believe I am physically and psychologically prepared to participate. 5. I agree that the parent(s) or legal guardian(s) will instruct the minor participant that prior to participation he/she should inspect the facilities and equipment to be used, and if the participant believes anything unsafe, he/she should immediately advise his/her coach or supervisor of such condition(s) and refuse to participate. 6. Assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death. 7. Agree to the refund policy. 8. HOFSTRA UNIVERSITY is not responsible or liable for any of the activities in respect to the camp; the camp director is an independent contractor. * Yes, I accept the waiver and consent to participate * Name of Person Completing This Event Consent/Waiver Form * US Lacrosse # INSURANCE INFORMATION 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 below. * Health Insurance Company: * Policy #: FOR ANY PARTICIPANT WHO IS NOT YET 18 YEARS OLD As parent or legal guardian of this participant, I hereby verify my signature below that I have read and fully understand each of the conditions under the Participant Waiver & Release section for permitting my child to participate in any lacroSSe by 3 INC. sponsored events and activities, and I accept each of the conditions, especially the waiver and release set forth above. I/We being the legal guardian of the applicant, authorize the lacroSSe by 3 INC. and its agents permission to request treatment as necessary to sure the well being of our dependent. * Signature of Parent/Guardian: