Bump & Grind Miami Lacrosse Tournament 2010 - Application

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Player Information
Event:	Bump & Grind Miami Lacrosse Tournament 2010
Team:
First Name:	*
Last Name:	*
Position:	*
Number:
Years Playing:	*
Other Team:	*
Status/Grade:	- Status/Grade of player when tournament starts.
DOB:	* ex) 05-27-1990
US Lacrosse Num:
Contact Information
Phone:	*
Email:	*
Street:	*
City:	*
State:	*
Zip:	*
Emergency Contact Information
Emergency Contact:	*
Emergency Phone:	*
Disclaimer
I verify that I/my child have/has been checked by a licensed physician prior to coming to this Lacrosse League/ tournament/ camp or clinic and is physically able to participate fully. I realize that lacrosse is a sport that involves aggressive play and physical contact, both of which can result in serious injury. Moreover, even with headgear, lacrosse players are susceptible to head and neck injuries. I understand the inherent risk involved and I hereby do assume all risks included in my/my child's participation in such activities. I agree to allow myself/my child to be treated by the staff at the closest hospital to the event, or any athletic training staff that this league may contract in the event of an injury or emergency. In addition, I assume all risks from the participation of myself or my child in this sporting event, and will hold harmless the township of Coconut Creek, league coaches, Bo Lamon, Lacrossewear Inc, and its employees of any and all liability, actions, causes of action, claims and demands of every kind and nature whatsoever which may arise in connection with or resulting from participation in any of its activities. By clicking Register, you agree to the terms of the Lacrossewear disclaimer above.