HUDSON AREA LACROSSE ASSOCIATION - Youth Development Fall Program Registration 2012Hudson Area Lacrosse Association 2012 Developmental Registration Form
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Required information is denoted with an asterisk (*). Your application cannot be submitted without providing information for those fields.
You will be prompted to pay via PayPal upon completion of this registration form.
***ALL PLAYERS ARE REQUIRED TO HAVE A US LACROSSE NUMBER TO REGISTER.
PLEASE REGISTER YOUR PLAYER AT WWW.USLACROSSE.ORG .
AGE GROUPS:
K - 2nd GRADES (BOYS & GIRLS)
⇒ Based on 12'-13' Grade Level ⇐
Registration Fees are:
$20 Per Player
(Mandatory $25 US Lacrosse membership separate)
Fees include: Field rental, coaching, & t-shirt.
Session One: Thursday's Aug 16th - Sept 13th 6:10 pm - 7:00 pm
PLAYER IS RESPONSIBLE FOR HAVING THE FOLLOWING EQUIPMENT:
Lacrosse or Hockey Helmet & Crosse Stick
ALL PLAYERS ARE REQUIRED TO HAVE A US LACROSSE MEMBERSHIP
Visit www.uslacrosse.org to register today.
Liability Waiver
* Agree that prior to participating, if present I will inspect the facilities & equipment, & if I believe
anything to be unsafe, will immediately advise my coach or supervisor of such conditions.
* Acknowledge & fully understand that each player is voluntarily participating in activities that
involve risk of injury (including catastrophic injury, or death) which might result not only from
their own actions, inactions, or negligence, but the actions, inactions, or negligence of others,
the rules of play, the conditions of the premises, or any of the equipment used. This includes any
risks not forseeable to the HALA.
* Assume all the foregoing risks as a condition of participation & accept personal responsibility
for the damages following any such injury.
* Unconditionally release, waive, & consent not to sue Hudson Area Lacrosse Association (HALA),
officers, directors, administrators, agents, coaches,other employees, and volunteers of the HALA,
sponsoring agencies, sponsors, advertisers for any & all liability to the undersigned, their heirs,
or next of kin. This is for any claims or losses on account of injury, including death, or damage
to property, while participating in any & all of the HALA's official or unofficial activities, events, or competitions.
* Accept responsibility for the coach's and/or player's decision to continue participation if suffering from injuries.
* Give permission for medical data to be used anonymously in medical education & published
studies of injury statistics & analysis. Consent to use, without compensation, my picture, name, voice,
or likeness for promotional, television, radio, or film coverage of HALA events.
* Permission to Administer Medical Care - by agreeing to this waiver, you have accepted responsibility
for all medical expenses incurred whether or not you are covered by insurance.
As the parent/guardian of the participant named above, I request that in my absence, the named player
be admitted to any hospital or medical facility for diagnosis & treatment. In case of injury, accident or illness,
I authorize the head coach & on-site volunteer medical/first aid staff to provide appropriate medical treatment.
If an emergency transport is deemed necessary, I authorize the same to summon an ambulance
and transport the player to the hospital. I request & authorize physicians, athletic trainers, technicians,
first aid personnel, nurses, & dentists to perform any diagnostic, treatment, or operative procedures,
& x-rays for the named player. I have been given no guarantees as to the results of examination or treatment.
* I accept total responsibility for any and all medical costs of the above player.
* I agree to possess health and dental insurance as a condition to my/my child's participation.
*MEMBERSHIP IN US LACROSSE IS MANDATORY AND OFFERS MANY BENEFITS THAT CAN
BE VIEWED AT WWW.USLACROSSE.ORG
**By submitting this application you agree to the terms and conditions listed in this liability waiver.
You will be prompted to Pay via payPal upon completion of this registration form by following the link of the session you would like to register for.
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