TOURNAMENT: Hershey Lacrosse 2015Hershey InvitationalU11 LaxTournament

LIABILITY WAIVER AND RELEASE

EVERY PARTICIPANT’S PARENT OR GUARDIAN MUST READ THIS WAIVER FORM AND SIGN IN THE APPROPRIATE SPACE. SIGNATURES ON THIS FORM SIGNIFY EACH PERSON HAS READ THIS WAIVER, UNDERSTANDS IT, AND VOLUNTARILY AGREES TO ABIDE BY ITS TERMS. NO PARTICIPANT MAY PLAY WITHOUT A SIGNED AND SUBMITTED WAIVER.

WITH MY SIGNATURE BELOW, IN CONSIDERATION FOR MY CHILD’S PARTICIPATION IN THE GAME OF LACROSSE, I HEREBY RELEASE, ACQUIT AND FOREVER DISCHARGE, INDEMNIFY AND HOLD HARMLESS, FROM AND AGAINST ANY AND ALL CLAIMS, DEMANDS, ACTIONS OR CAUSES OF ACTION, FOR LIABILITY FOR BODILY INJURY OR OTHER DAMAGES ARISING OUT OF, OR IN ANY WAY RELATED TO, MY CHILD’S PARTICIPATION IN THEHershey Lacrosse 2015 Hershey InvitationalU11 Lax Tournament, THE HERSHEY LACROSSE ASSOCIATION, THE MILTON HERSHEY SCHOOL, THE HERSHEY TRUST, THE TOWNSHIP OF DERRY, PENNSYLVANIA & THE DERRY TOWNSHIP SCHOOL DISTRICT INCLUDING ALL EMPLOYEES, COACHES AND VOLUNTEERS.

I UNDERSTAND MY CHILD’S PARTICIPATION IS ENTIRELY VOLUNTARY AND WILL INVOLVE PHYSICAL ACTIVITY. I ALSO UNDERSTAND THAT THERE IS A RISK OF BODILY INJURY FROM MY CHILD’S PARTICIPATION IN THIS ACTIVITY. TO MY KNOWLEDGE, MY CHILD IS NOT AFFECTED BY A PHYSICAL CONDITION OR DISABILITY THAT WOULD PROHIBIT HIM/HER FROM SAFELY PARTICIPATING IN THIS ACTIVITY.

BY SIGNING THIS AGREEMENT, I AM GRANTING PERMISSION FOR MY CHILD TO PLAY IN THE Hershey Lacrosse 2015Hershey InvitationalU11 Lax Tournament.

I UNDERSTAND THAT THERE ARE RULES FOR THIS TOURNAMENT AND THAT OFFICIALS RESERVE THE RIGHT TO EJECT PLAYERS FROM THE GAME AND/OR THE TOURNAMENT FOR IMPROPER BEHAVIOR, DISRESPECTFULNESS OR OTHER CONDUCT WITHOUT REFUND OF FEES PAID, IF ANY. BY SIGNING THIS AGREEMENT, I AGREE THAT MY CHILD AND I SHALL ABIDE BY THE RULES OF THE TOURNMENT.

Team Name: ______

Player/Participant’s Name:______

Players Birth date: ____/____/_____

Parent/Guardian Signature:______

Date: / /2015