“The Snowcase”
Sunday December 4th 10 am-4:30 pm
Kinsley Field on The Campus of York College of PA.
One last chance to be seen, get coached, and work on your skills before your spring season gets started.
Cost: $75 (Checks Only)
Registration Form
Name:
Address: (City, State, Zip)
Position:
Grade (As of Fall 2011):
Contact Phone Number:
Contact e-mail:
Jersey Size: M_____ L______ XL_______ XXL
Amount Enclosed:
_______________$75 Checks Payable to York College Men’s Lacrosse
PLEASE FILL OUT INSURANCE AND WAIVER FORM AND ATTACH
TO APPLICATION.
RELEASE AND COVENANT NOT TO SUE
This is a legally binding release and covenant not to sue given by me,
__________________________________(print full name) to York College.
In consideration for receiving permission to participate in the York CollegeLacrosse Snowcase,
I am freely andvoluntarily entering into this release and covenant not to sue. I fully recognize that there are dangers and risks to
which I may be exposed by participating in the York College Lacrosse Snowcase. Examples of these risks and dangers include the risk of catastrophic injury, paralysis and even death, as well as other damages and losses, associated with participation in a lacrosse event and related sports conditioning activities.
I understand that York College does not require me to participate in thisactivity, but I want to do so despite the dangers and risks and despite this release and covenant not to sue.
I therefore agree to assume and take on all of the risks and responsibilities inany way associated with this activity. In consideration of and return for being permitted to participate in this activity, and for the services, facilities and other things provided to me by York College in this activity, I HEREBY RELEASE YORK COLLEGE (and its trustees, employees or agents) FROM ANY AND ALL LIABILITY, CLAIMS AND ACTIONS THAT MAY ARISE FROM INJURY OR HARM TO ME, FROM MY DEATH OR FROM DAMAGE TO MY PROPERTY IN CONNECTION WITH THIS ACTIVITY. I
UNDERSTAND THAT THIS RELEASE AND COVENANT NOT TO SUE COVERS LIABILITY, CLAIMS AND ACTIONS CAUSED ENTIRELY OR IN PART BY ANY ACTS OR FAILURE TO ACT OF YORK COLLEGE (or its trustees, employees or agents), INCLUDING, BUT NOT LIMITED TO, NEGLIGENCE, MISTAKE OR FAILURE TO SUPERVISE BY YORK COLLEGE.
I recognize that this release and covenant not to sue means I am giving up, among other things, rights to sue York College for injuries, damages or losses that I may incur. I also understand that this release binds my heirs, executors, administrators and assigns as well as myself.
I have read this entire release and covenant not to sue, I fully understand it, and I agree to all of the terms and conditions as stated herein. Participant Waiver (Signature is required in order to participate) In consideration of my participation in the York
College Lacrosse Snowcase sponsored events and activities, I agree to the following:
1. Medical Attention: I hereby give my consent to the York College 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 York College Lacrosse Snowcase sponsored or sanctioned events.
2. Readiness to compete: I will only participate in those conditioning or activities in which I believe I am physically and psychologically prepared to participate.
Participant Primary Medical
Insurance Carrier: _______________________________ Policy #_______________________
Signature of
Participant______________________________________________
FOR ANY PARTICIPANT WHO IS NOT
YET 18 YEARS OF AGE: As a legal guardian of this participant, I hereby verify by my signature below that I have read and fully understand each of the above conditions for permitting my child to participate the York College Snowcase, and I accept each of the above conditions.
Signature of
Guardian_____________________________
Printed Name____________________________________ Date_____________________________
Brandon Childs
York College Men’s Lacrosse
York College
441 Country Club Road.
York, PA. 17403
717-880-6200
or e-mail to: bchilds2@ycp.edu
