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EMW Lacrosse
Health and
Waiver Form

Please complete the this form before moving on to payment. 

This form must be completed for every child and for every session played at EMW Lacrosse. 

Is your child either currently enrolled or living in the Iroquois Central School District?
Are you filling out this form form Boys Lacrosse or Girls Lacrosse?
What is your child's current grade level?
Please select any of the following current of previous health conditions of registering EMW Lacrosse Player

EMW LACROSSE WAIVER

SECTION 1 - RULES AND REGULATIONS

 

I understand that should our current EMW Lacrosse program be postponed or cancelled, my child as a participating EMW Lacrosse player will only be eligible for EMW Lacrosse credit for future lacrosse participation.  I understand that refunds will not be an option.

WAIVER & RELEASE OF LIABILITY: I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis and even death, as well as other damages and losses, associated with participation in a lacrosse event. I further agree on behalf of myself, my heirs, and personal representatives, that EMW Lacrosse, the host organization, and sponsors of any EMW Lacrosse sanctioned event, along with the coaches, volunteers, employees, agents, officers and directors of these organizations, shall not be liable for any injury, loss of life or other loss or damage occurring as a result of my participation in the event.

I release, waive, discharge and covenant not to sue EWM Lacrosse, its affiliated clubs, their respective administrators, directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and leasers of premises used to conduct the event, all of which are hereinafter referred to as “releases”, from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.

​MEDICAL ATTENTION: I hereby give my consent to EMW Lacrosse and the host organization of any EMW Lacrosse sanctioned event to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my participation in EMW Lacrosse sanctioned events.

​READINESS TO COMPETE: I will only participate in those EMW Lacrosse competitions for which I believe I am physically and psychologically prepared to compete.

​I will adhere to the New York State COVID-19 guidelines regarding current restrictions and quarantine procedures.  Furthermore I understand that my child as a participating EMW Lacrosse player should not attend EMW Lacrosse sessions if they are experiencing any symptoms of COVID-19 including a fever exceeding current NYS guidelines.

EMW LACROSSE WAIVER SECTION 1 - RULES AND REGULATIONS

EMW LACROSSE WAIVER

SECTION 2 - CONCUSSIONS

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I have read and understand the signs and risks of concussions while playing the sport of lacrosse explained in the section above entitled EMW Lacrosse Waiver Section 2 - Concussions

EMW LACROSSE WAIVER SECTION 3

CODE OF CONDUCT

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All parents/guardians and EMW Lacrosse participating players will comply with the EMW and US Lacrosse Code of Conduct as written in the above document. I understand that failure to comply with this agreed Code of Conduct on behalf of the the player or their family members will result in the immediate removal from all current and future EMW Lacrosse activities for any and all family members involved.

EMW LACROSSE WAIVER SECTION 3 CODE OF CONDUCT

EMW LACROSSE WAIVER SECTION 4

PHOTOGRAPH AND VIDEO CONSENT

PHOTOGRAPH AND VIDEO CONSENT: I hereby give my permission to the EMW Lacrosse to use photographs or videotapes of my child for public relations or other purposes consistent with the purpose and mission of EMW Lacrosse.  I further agree that said materials shall become the property of the EMW Lacrosse, and I hereby release and discharge EMW Lacrosse and its representatives from any and all claims that may arise by reason of taking said photographs or pictures.  

PHOTOGRAPH AND VIDEO CONSENT

I give permission for EMW Lacrosse to use my child's photo and/or name on the EMW Lacrosse website. I am fully aware of what is included on EMW Lacrosse’s website, and appreciate the risks associated with the Internet. I further agree on behalf of myself, my heirs, and personal representatives, that EMW Lacrosse, along with the coaches, volunteers, employees, agents, officers and directors of this organization shall not be liable for any negative events occurring as a result of my participation on EMW Lacrosse website.

EMW LACROSSE WEBSITE CONSENT
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