I am fully aware of and appreciate the risks, including the risks of catastrophic injury, paralysis and even
death, as well as other damages and losses, associated with participation in a lacrosse event. I agree on behalf of myself, my
heirs and personal representatives, that US Lacrosse, the host organization and the sponsor or sponsors with respect to a
Covered Event, together with coaches, officials, volunteers, employees, agents, officers and directors of the host organization
and any such sponsors shall not be held liable for any injury, loss of life or other loss or damage as a result of my participation in
a Covered Event. This Waiver & Release shall also be for the benefit of and run in favor of any
youth organization that requires participants to become members of US Lacrosse as a condition to their participation in such
organization’s youth lacrosse events, which shall constitute Covered Events for purposes of this Waiver & Release, and any such
youth lacrosse league shall constitute the host organization for such Covered Events.
As a condition to, and in consideration for allowing my child(the Participant) to participate in the activities organized, sponsored or sanctioned by the Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse, I (i) give permission to Trenton BRIDGE Lacrosse coaches and staff to supervise Trenton BRIDGE Lacrosse-related activities and travel of my son/daughter and (ii) give my permission and consent to Trenton BRIDGE Lacrosse and any host organization to provide, through a medical staff of its choice, customary medical/athletic training attention and transportation and emergency medical services as warranted in the course of my son/daughter’s participation in Trenton BRIDGE Lacrosse sanctioned events. 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 my child’s participation in Trenton BRIDGE Lacrosse sanctioned events, including but not limited to lacrosse competition, camps, field trips and transportation. I agree on behalf of myself, my child and our heirs and/or personal representatives, that Trenton BRIDGE Lacrosse, the host organization and sponsors/hosts of any Trenton BRIDGE Lacrosse sanctioned event, including but not limited to the facilities of the Marie Katzenbach school f/t Deaf, The Village Charter School and the Boy’s and Girls’ Clubs of Trenton, along with the coaches, volunteers, employees, agents, officers and directors of those organizations and any medical staff and trainers (as specified above) shall not be liable for any injury, loss of life, loss of property, or other loss or damage occurring as a result of my child’s participation in any Trenton BRIDGE Lacrosse sanctioned events. I also agree that neither the Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse nor its employees, staff, coaches or volunteers will be responsible for my child after practice and/or camp hours and they shall not be responsible for releasing my child to specific individuals.
In consideration of my membership in US Lacrosse, and my participation in US Lacrosse sanctioned, recognized or sponsored
events (“Covered Events”), I agree to the following:
BRIDGE PROGRAM PLAYER
MEMBERSHIP AGREEMENT (SIGNATURES REQUIRED FOR ACCEPTANCE OF MEMBERSHIP)
Waiver and Release:
I understand that the Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse will not be legally responsible for my son/daughter before or after practice hours and games. I also understand that the Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse will not be responsible for releasing participants to specific individuals or for transporting my son/daughter on practice/game days.
Transportation Waiver:
I hereby give permission to the Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse to reproduce any quotation, photograph or video of my son/daughter while participating in any on or off-field Trenton BRIDGE Lacrosse sanctioned activity. Photo and/or video reproductions may appear, at no cost to the Bobby Campbell lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse, in program reports, grants, newsletters, on the Bobby Campbell Lacrosse Foundation or Trenton BRIDGE Lacrosse websites, in marketing materials and in local/national publications.
Photo and Quotation Waiver:
As legal parent or guardian of this participant, I hereby verify by my signature below that I fully understand and accept each of the above conditions for permitting my child to participate in any Bobby Campbell Lacrosse Foundation, Inc. dba Trenton BRIDGE Lacrosse sanctioned and/or sponsored activity. I also acknowledge and agree that this Participation Waiver shall remain in effect until I revoke it by written notice to the Bobby Campbell Lacrosse Foundation Inc. dba Trenton BRIDGE Lacrosse or until I sign a new Participation Waiver at a later date.
Parents/Guardians:
Parent Signature:
WAIVER & RELEASE:
Parent Signature:
Participant Signature:
MEDICAL ATTENTION:
I hereby give my consent to US Lacrosse and the host organization of any Covered Events to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency services
as warranted in the course of my participation in Covered Events.
READINESS TO COMPETE:
INFORMATION CERTIFICATION:
I certify that all of the information provided by me in this application, including without limitation my membership category, is true,
accurate, and complete and I understand that any untrue, inaccurate or incomplete statement or information will automatically
invalidate my membership and all of the benefits of membership in US Lacrosse.
CODE OF CONDUCT:
I agree to all terms on the
reverse side of this form (refers to accepted US Lacrosse/Positive Coaching Alliance Code of Conduct).
I certify that all information provided by me in this application , including without limitation my membership category, is true, accurate and complete and I understand that any untrue, inaccurate or incomplete statement or information will automatically invalidate my membership and all of the benefits of membership in US Lacrosse.
I hereby give my consent to US Lacrosse and the host organization of any covered event to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency services as warranted in the course of my participation in Covered Events.
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 agree on behalf of myself, my heirs and personal representatives that US Lacrosse, the host organization and the sponsor or sponsors with respect to a Covered Event, together with coaches, officials, volunteers, employees, agents, officers and directors of the host organization and any such sponsors shall not be held liable for any injury, loss of life or other loss or damage as a result of my participation in a Covered Event. This Waiver and release shall also be for the benefit of and run in favor of any youth organization that requires participants to become US Lacrosse members as a condition of their participation in such organization’s youth lacrosse events, which shall constitute Covered Events for purposes of this Waiver and Release, and any such youth lacrosse league shall constitute the host organization for such Covered Events.
US LACROSSE AND THE POSITIVE COACHING ALLIANCE
Lacrosse is the oldest American sport. Native Americans played lacrosse centuries ago, long before our colonies were settled. Through lacrosse, Native Americans celebrated and emphasized their spiritual and cultural values. In an effort to promote appropriate values in the modern game, US Lacrosse has partnered with the Positive Coaching Alliance to promote positive coaching and good sportsmanship at all levels of lacrosse. US Lacrosse has included the following “Lacrosse Code of Conduct” as part of its membership application to encourage and foster appropriate values in players, coaches, parents and spectators. US Lacrosse believes that it should be a priority of every lacrosse player, team, program and league to “Honor the Game”.
US LACROSSE CODE OF CONDUCT
Players, coaches, officials, parents and spectators are to conduct themselves in a manner that “Honors the Game” and demonstrates respect to other players, coaches, officials, parents and fans. In becoming a member of the lacrosse community an individual assumes certain obligations and responsibilities to the game of lacrosse and its participants. The essential elements in this “Code of Conduct” are HONESTY and INTEGRITY. Those who conduct themselves in a manner that reflects these elements will bring credit to the sport of lacrosse, themselves, their team and their organization. It is only through such conduct that our sport can continue to earn and maintain a positive image and make its full contribution to amateur sports in the United States and around the world. US Lacrosse supports the following behaviors for those who participate in the sport or are involved in any way with US Lacrosse. The following essential elements of the “Code of Conduct” must be followed:
•
Sportsmanship and teaching the concepts of fair play are essential to the game and must be taught at all levels and developed both at home and on the field during practices and games.
Sportsmanship and teaching the concepts of fair play are essential to the game and must be taught at all levels and developed both at home and on the field during practices and games.•The value of good sportsmanship, the concepts of fair play, and the skills of the game should always be placed before winning. The safety and welfare of the players are of primary importance.
The value of good sportsmanship, the concepts of fair play, and the skills of the game should always be placed before winning. The safety and welfare of the players are of primary importance.•Coaches must always be aware of the tremendous influence they have on their players. They are to strive to be positive role models in dealing with young people as well as adults.
Coaches must always be aware of the tremendous influence they have on their players. They are to strive to be positive role models in dealing with young people as well as adults.•Coaches should always demonstrate positive behaviors and reinforce them to players, parents, officials and spectators alike. Players should be specifically encouraged and positively reinforced by coaches to demonstrate respect for teammates, opponents, officials and spectators.
Coaches should always demonstrate positive behaviors and reinforce them to players, parents, officials and spectators alike. Players should be specifically encouraged and positively reinforced by coaches to demonstrate respect for teammates, opponents, officials and spectators.•Coaches, players, parents and spectators are expected to demonstrate the utmost respect for officials and reinforce that respect to players/teammates. Coaches are also expected to educate their players as to the important role of lacrosse officials and reinforce the ideal of respect for the official to players/teammates.
Coaches, players, parents and spectators are expected to demonstrate the utmost respect for officials and reinforce that respect to players/teammates. Coaches are also expected to educate their players as to the important role of lacrosse officials and reinforce the ideal of respect for the official to players/teammates.•Grievances or misunderstandings between coaches, officials or any other parties involved with the sport should be communicated through the proper channels and procedures, never on or about the field of play in view of spectators and participants.
Grievances or misunderstandings between coaches, officials or any other parties involved with the sport should be communicated through the proper channels and procedures, never on or about the field of play in view of spectators and participants.•Officials are professionals and are therefore expected to conduct themselves as such and in a manner that demonstrates total impartiality, courtesy and fairness to all parties.
Officials are professionals and are therefore expected to conduct themselves as such and in a manner that demonstrates total impartiality, courtesy and fairness to all parties.•Spectators involved with the game must never permit anyone to openly or maliciously criticize, badger, harass or threaten an official, coach, player or opponent.
Spectators involved with the game must never permit anyone to openly or maliciously criticize, badger, harass or threaten an official, coach, player or opponent. •Coaches must be able to demonstrate a solid knowledge of the rules of lacrosse and should adhere to the rules in both the letter and the spirit of the game.
Coaches must be able to demonstrate a solid knowledge of the rules of lacrosse and should adhere to the rules in both the letter and the spirit of the game. •Coaches should provide a basic knowledge of the rules to both players and spectators within his/her program. Attempts to manipulate rules in an effort to take unfair advantage of an opponent, or to teach deliberate unsportsmanlike conduct is considered unacceptable conduct.
Coaches should provide a basic knowledge of the rules to both players and spectators within his/her program. Attempts to manipulate rules in an effort to take unfair advantage of an opponent, or to teach deliberate unsportsmanlike conduct is considered unacceptable conduct.•Eligibility requirements at all levels of the game must be followed. Rules and requirements such as age, previous level of participation, team transfers etc. have been established to encourage and maximize participation, fair play and to promote safety.
Eligibility requirements at all levels of the game must be followed. Rules and requirements such as age, previous level of participation, team transfers etc. have been established to encourage and maximize participation, fair play and to promote safety.In consideration of my membership in US Lacrosse and my participation in US Lacrosse sanctioned, recognized and sponsored events (“Covered Events”), I agree to the following:
As parent or legal guardian of this participant, I hereby verify by my signature below that I fully understand and accept each of the above conditions.
I agree to all terms on this form (refers to accepted US Lacrosse/Positive coaching alliance Code of Conduct).
I will only participate in those Covered Events in which I believe I am physically and psychologically prepared to compete.
2013 Bridge Membership Registration Form
BRIDGE ORGANIZATION TEAM NAME: The Bobby Campbell Lacrosse Foundation, Inc. dba Trenton Bridge Lacrosse
Participant Contact Information
Current USL Member #:
First Name:
Street Address:
City:
Date of Birth:
Middle Name:
Apt #:
State:
Home Phone:
Last Name:
Email:
Zip Code:
Parent/Guardian Information
Registration Fee: $45 (Checks payable to the Bobby Campbell Lacrosse Foundation)
Parent/Guardian #1 Name:
Work Phone:
Cell Phone:
Relation to Player:
EMAIL:
Parent/Guardian #2 Name:
Work Phone:
Cell Phone:
Relation to Player:
EMAIL:
Emergency Contact Information (must be different than parent/guardian)
Emergency Contact #1 Name:
Work Phone:
Cell Phone:
Relation to Player:
Emergency Contact #2 Name:
Work Phone:
Cell Phone:
Relation to Player:
Additional Information
Gender:
Race/Ethnicity:
School:
Grade:
Shoe Size:
Primary Language Spoken at Home:
T-Shirt Size:
Medical Information
Allergies:
Medications:
Additional Medcical Concerns:
Primary Care Physician:
Physician's Phone:
Primary Medical Insurance Provider:
Policy Number:
Name of Policy Holder:
ENROLLMENT FORM AND MEMBER AGREEMENT
Signature Required for Acceptance of Membership
1. Waiver and Release:
2. Medical Attention:
3. Readiness to Compete:
4. Information Certification:
5. Code of Conduct:
Participant Signature:
Parent Signature:
If Participant is under 18, please read and sign below:
I will only participate in those Covered Events in which I believe I am physically and psychologically prepared to compete.
