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LIABILITY FORM

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LIABILITY FORM

 
FIRST FACE-OFF CLASSIC 2012
 
 
 
PLAYERS NAME                                                                  TEAM NAME                              
 
 
PLAYERS EMAIL ADDRESS                                                                                                     
 
 
WAIVER OF LIABILITY
 
 

In consideration of participating in the First Face-Off Classic, the player named above and the parent or guardian do hereby agree for ourselves, our heirs, executors and administrators, to release, hold harmless and forever discharge Hempfield Lacrosse and First Face-Off Classic the their officers, staff, administrators, volunteers, sponsors and representatives and assigns, for and against any and all claims, actions, cause of actions, suits, judgments, and demands whatsoever directly or indirectly in connection the player’s participation in the First Face-Off Classic.

 

By signing below, I acknowledge that I have read and understand this form and further understand the terms herein are contractual and not a mere recital.

 
 
Signature of Parent/Guardian                                                                     Date                          
 
 
 
 
TREATMENT/MEDICAL RELEASE AUTHORIZATION
 

I/we being the legal guardians of the applicant authorize the staff of Hempfield Lacrosse and First Face-Off Classic and its agents permission to request treatment to ensure the well being of our dependant. I certify that he is in good health and able to participate in the scheduled games. I am attaching a note explaining any physical limitations and/or required medical attention that is necessary for my son.

 
 
Signature of Parent/Guardian                                                                     Date                          
 
Health Insurance Company                                                                                    
 
Health Insurance Policy Number