Polar Bear Meltdown LAX Tournament

 Saturday, March 14, 2009

TEAM MEDICAL RELEASE/ROSTER

My child has my/our permission to participate in the Polar Bear Lax Meltdown tournament.  I/we realize in this tournament, he/she may be accidentally injured.  I/we certify that he/she is physically able to participate in this tournament.

MEDICAL RELEASE:  I hereby give permission for any and all skill medical attention to be administered to my child in the event of an accident, injury, sickness, etc.  Administration of such will be under the direction of the Polar Bear Lax Meltdown Tournament coaches, referees, or officials until such time as I may be contacted.  I also hereby, assume responsibility for payment of any such treatment.

WAIVER:  In consideration of being permitted to participate in this Polar Bear Lacrosse Tournament, I do hereby for myself, my heirs, executors, administrators, and assignees release and forever discharge the tournament sponsors, the coaches, and all those persons involved in organizing and manning this tournament from all claims, demands damage actions, causes of action, or suits of whatsoever kind of nature arising out of my child’s participation in this tournament.

I hereby swear that the parent signatures listed above are legal and correct. 

___________________________  Coach’s Name 

____________________________Coach’s Signature

Date _________________