Wildcat Boys Lacrosse Club Consent, Release & Indemnity Agreement 2017-2018
We, the undersigned, for and in consideration of providing the undersigned Player with the opportunity to participate in the Wildcat Boys Lacrosse Club, do hereby unconditionally release and agree to indemnify and hold harmless the Wildcat Boys Lacrosse Club, or any other person, coach, volunteer or entity employed by or associated with them from any type of and all claims for personal injury, death, property damage or any type of claim or damage [including, but not limited to, attorney’s fees and litigation expenses] resulting from or arising out of the undersigned Player’s participation in the sport of lacrosse or transportation to and from events with the Wildcat Boys Lacrosse Club for the 2017-2018 season.
We, the undersigned, hereby consent and grant to the coach or volunteers of the Wildcat Boys Lacrosse Club with express authority and discretion, but not the requirement, to provide any medical or emergency services needed by the undersigned parent being financially responsible for such services.
The undersigned represents that the Player is physically and psychologically able and prepared to participate in the sport of lacrosse, and they understand and accept the fact that sports, including lacrosse, involve risk of injury and bodily harm, including paralysis and death, which risks the undersigned voluntarily and knowingly assume.
This ___________ day of _____________, 201__.
Player Signature Parent/Guardian Signature
Player Printed Name Parent/Guardian Printed Name P.4
Wildcat Boys Lacrosse Club Medical/Liability Release Form 2017-2018
I, ________________________________, authorize a member of the Savannah Lacrosse
Club to provide emergency treatment of any injury and/or illness of my child,
_______________________, and release said member of any liability.
Phone:___________________________ Cell: _____________________________
Family physician: ________________________________ Phone:___________________
Pre-existing conditions: _____________________________________________________
Medications being taken: ____________________________________________________
Other emergency contacts: __________________________________________________
Preferred hospital: _________________________________________________________
Insurance information: Name:___________________________________________________________________
Policy #: _____________________ Group #: ______________ ID#:_________________
I understand this informed consent and release of liability form and agree to its conditions on behalf of my child.
Parent/Guardian Signature ________________________________
Wildcat Boys Lacrosse Club
2016 Practice Pinny Agreement
Wildcat Boys Lacrosse Club Pinny Agreement:
To receive a Practice Pinny the undersigned Player and Parent must have Booster dues ($50.00) paid in full, a signed waiver and signed Pinny agreement.
Please Print Clearly
Age: ________ DOB: _______________ Grade: _________
Home Address: ________________________________________________________________________________
State: ______________ Zip Code: _______________
Cell: ______________________________ Other Contact Number: _________________________________
Name (s): _______________________________________________________________________________
Cell phones: _____________________________________________________________________________
Work phones: ____________________________________________________________________________
If not returned at the end of season or dismissal from the team the undersigned agrees to pay $30 to Wildcat Boys Lacrosse Booster Inc.
Player Signature________________________________ Date _______________________
Parent Signature _________________________________ Date ________________________
WBLC is a volunteer run organization that seeks to promote the great game of lacrosse and provide our youth an opportunity to play lacrosse in a wholesome and safe environment that stresses good sportsmanship and fair play. All WBLB executive board members and coaches are volunteers. The best interests of the players will always be the priority.