2024 LYSA WAIVER AND RELEASE OF LIABILITY: READ BEFORE SIGNING

LYSA WAIVER AND RELEASE OF LIABILITY: READ BEFORE SIGNING
In consideration of being allowed to participate in any way in Longwood Youth Sports Association athletic sports program, related events and activities, the undersigned acknowledges, appreciates, and agrees that: The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) from the activities involved in this program are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, 2. 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 participation; and, .1 I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, .4 ,I for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Longwood Youth Sports Association their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND AL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. IHAVEREADTHIS RELEASEOFLIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY ANDVOLUNTARILY WITHOUT ANY INDUCEMENT.
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ATHLETE WAIVER
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example@example.com
Emergency Contact

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Emergency Contact Phone Number

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List Allergies
Medical Conditions
Medications
EACH ATHLETE IS RESPONSIBLE FOR CARRYING THEIR OWN INSURANCE
Health Insurance
ID #
Subscriber Name

First NameLast Name
Subscriber Date of Birth

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Primary Care MD
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CERTIFICATION OF PHYSICAL FITNESS TO PARTICIPATE:
1. I understand that a risk of participating in any sport, including Lacrosse, increases therisk of injury, including but not limited to serious permanent injury, paralysis, and death. To minimize the risk of injury, the athlete agrees to obey all safety rules and to report fully any problems related to his/her physical condition to the event coordinators as soon as the problem arises.
2. By signing the registration form, I certify the following:
a. That the participating athlete is not currently under the care of a physician for an injury or illness that would prevent his/her safe participation in the sport.
b. That the athlete is not currently being treated for or recovering from an orthopedic injury that would prevent his/her safe participation in the sport.
c. That the participating athlete has no history of fainting or other problems related to strenuous exercises.
d. That the athlete is in good health and there is no reason he/she cannot safely
participate in strenuous physical activity.
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LYSA WAIVER AND RELEASE OF LIABILITY: READ BEFORE SIGNING

ATHLETE WAIVER

CERTIFICATION OF PHYSICAL FITNESS TO PARTICIPATE: