Parent/Guardian Information

Emergency Information

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities of San Diego Girls Lacrosse during the selected practice or lesson. In exchange for the acceptance of said child’s candidacy by San Diego Girls Lacrosse, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless San Diego Girls Lacrosse and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of travel to, participating in, or returning from practice or lessons.

There is a risk of being injured that is inherent in all sports activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, Covid, or death.

In case of injury to said child, I hereby waive all claims against San Diego Girls Lacrosse, including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event.

Furthermore, all images and videos of San Diego Girls Lacrosse are the property of San Diego Girls Lacrosse and can be used for any promotional consideration.

I hereby state that I have carefully read the above waiver. Acceptance and understanding of this agreement are hereby acknowledged.

Medical Release and Authorization

As Parent and/or Guardian of the named child, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named child. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to San Diego Girls Lacrosse leaders and parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates of the registered lessons.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

Parent Commitment COVID Form

By completing this form and participating in the this program, you must confirm that you and your child will abide by the most current guidelines of the County of San Diego Public Health Order. 

ASSUMPTION OF RISK / WAIVER OF LIABILITY / INDEMNIFICATION AGREEMENT

In consideration of being allowed to participate on behalf of San Diego Girls Lacrosse athletic program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation as regards protection against infectious diseases. If, however, I observe and any unusual or 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,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS (insert name of sports organization) 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 ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

You attest that you will not send your child to practice if their temperature is above 100° F or if they have COVID symptoms based on CDC guidelines.
https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

You attest that if your child has displayed COVID symptoms, you will not allow them to return to practice until they have tested negative for COVID and provide a medical professional’s clearance; or at least 10 days have passed since the onset of symptoms, and at least 3 days (72 hours) have passed since recovery (no fever without the use of fever reducing medication).

Participants must bring enough water as drinking fountains will not be available.

Please be sure to

click the "SUBMIT" button below.

See you on the field!

Thank you!