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McLean Youth Lacrosse, BOX Lacrosse League, Medical Agreement & Release of Liability for Minors & Adults: 2018


Player Name:___________________________________             Team:                                                                  ____________

In Consideration of my registration in McLean Youth Lacrosse, and my participation in McLean Box Lacrosse League, teams and events (Summer & Fall McLean BOX Lacrosse League), I agree to the following for my child or myself if 18 years old or older:

1. READINESS TO COMPETE: He/she will only participate in those McLean Youth Lacrosse, Club events and competitions for which we as parents believe he is physically and psychologically prepared to compete.

2. MEDICAL ATTENTION: I hearby give my consent to McLean Youth Lacrosse, Club and the host organization of any McLean Youth Lacrosse, Club sanctioned event 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 childs participation in McLean Youth Lacrosse, Club teams and sanctioned events.

3. My child has current medical health Insurance that covers any risk of participation in McLean Youth Lacrosse, Club teams and sanctioned events. Medical Health Insurance can also be obtained by becoming a US Lacrosse Member.

In consideration of my minor child/ward being allowed to participate in any way in the McLean Youth Lacrosse program related events and activities, my acceptance below, the undersigned acknowledges, appreciates, and agrees that:

1) The risk of injury to my child/ward and myself as an Adult from activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist: and,

2) FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume full responsibility for my childs/wards participation; I RELEASE the following organizations from any Liability: McLean Youth Lacrosse, Burke Athletic Club, Lake Braddock HS, McLean HS, Fairfax County Public Schools, David Morris, Tony Gray, and Tom Sullivan, and,

3) I willingly agree to comply with the programs stated and customary terms and conditions for participation. If I observe any unusual significant concern in my childs or myself as an Adult readiness for participation and/or in the program itself, I will remove my child or myself as an Adult from participation and bring such attention of the nearest official immediately; and,

4) I myself, my spouse, my child/ward, myself as an Adult, and on behalf of my/our heirs, assigns, personal representatives and next of next of kin, HEREBY RELEASE THE sponsors, and if applicable, owners and lessors of premises used to conduct the event (Releasees), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my childs involvement or participation in these programs or myself as an Adult, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.

5) I, for myself, my spouse, my child, myself as an Adult, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

I accept the above*     



 Parent  Signature____________________________(If under 18)_Print Name________________________ DATE________­­­­­­­­



Player Signature_____________________________(If over 18)_Print Name_________________________DATE________


Please Print and turn in to Bucky Morris before first game of Summer and or Fall 2018


McLean Youth Lacrosse, PO Box 6293, McLean, VA 22106