Applefest Shootout Lacrosse Tournament
Each of the undersigned hereby states: 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 tournament or lacrosse event. I agree on behalf of myself, my heirs, and personal representative that the Warwick Youth Lacrosse, Applefest Shootout Lacrosse Tournament and their members, owner, director, agents, employees and volunteers (collectively the “Covered Parties) shall not be held liable for any injury, damage to personal property, loss of life or other loss or damage as a result of my participation in the 2017 Applefest Shootout or any activities relating to the Applefest Shootout or conducted by the Covered Parties. It is my specific intention that none of the Covered Parties shall have liability whatsoever as a result of or in connection with my participation in the Applefest Shootout Lacrosse Tournament; I hereby waive any claims that I might have against any Covered Parties and release all Covered Parties from any such liability; and I agree to indemnify the Covered Parties against any such claims. In addition, I hereby give my consent to Warwick Youth Lacrosse, the owners and operators of the Applefest Shootout Lacrosse Tournament and all other Covered Parties to provide, through medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my participation in activities related to the Applefest Shootout Lacrosse Tournament. . Not withstanding the foregoing, I understand and agree that none of the Covered Parties have any obligation to provide any such medical/athletic training attention and the lack of any such medical/athletic training attention or the provision thereof on a voluntary basis shall be covered by the waiver and release set forth in this paragraph.
Print Applicant’s Name: ________________________________ Team Name & Age Group___________________________
Applicant’s Signature: _________________________________ Date: __________
Print Parent/Guardian Name: ___________________________________________
Parent/Guardian Signature: ____________________________________________
Heath Insurance: _____________________________________________________
Policy #: ____________________________________________________________