Liability/Injury Waiver and Release

Player Name 

Do you currently have medical insurance  Yes/No

Emergency Contact            

Emergency Phone

I am familiar with the nature of the game of lacrosse. I understand that participation in lacrosse can be dangerous and I accept all risk of injury and death. I accept that WALAX Summer League is only providing an opportunity to play in summer league games, in consideration for the privilege to play, I agree to assume all risks and release and hold harmless, Walax Summer League, it�s staff, agents, owners, officers property owners, league directors, officials, sponsors and any others having an interest in the league from all liability, negligence, causes of action, claims, demands and damages of every kind which may arise out of my participation in any and all activities at this Summer League.

I will insure that I will familiarize myself with the rules of the game and of the field and will to the best of my ability play under control and avoid injury to myself and other persons playing the game.  I understand that my participation privilege may be revoked and is non-refundable and non-transferable. I accept any and all risk as described above and acknowledge so by signing below.

Signature: ______________________________________      Age:      Date

If under 18, parental signature is required as well. Parents Signature:                                                                       Date:  

Please complete and return this form with $70 check (Payable to Stephanie Cone) 364 Highland Drive, Seattle WA 98109