Waiver of Liability

2008 Star Spangled Banner Tournament


Club Name_____________________________________ Jersey #___________

Please complete all fields, sign (athlete and parent/guardian) and give to your tournament coach.

First Name___________________________ Last Name________________________________

E-Mail_______________________________________________ Tourney Jersey #__________

Address_______________________________________________________________________

City_______________________________ State__________________ Zip_________________

High School__________________________________________________ Grad Yr___________

Waiver of Liability: In signing this application, I release Baldwinsville Girls Lacrosse Booster Club & all other involved parties from any claim or responsibility for injuries suffered in the tournament. I knowingly assume all risks associated with participation, even if arising from the negligence of the participants or others, and assume Full responsibility for my participation. I certify that I am in good physical condition and can participate in the Star Spangled Girls Lacrosse Tournament. Further, I authorize the site director to request medical treatment as necessary to insure my well being.

Athlete’s signature______________________________________________ Date___________

Parent/Guardian’s signature______________________________________ Date___________

Health Insurance Provider_______________________________________________________

Policy #_______________________________________________________________________














Coaches:
- please have each of your players sign one of these forms
- put them in numerical order
- place a roster on top of the pile
- then staple them