2015 SEASON FURY BOYS LACROSSE CLUB
AMATEUR ATHLETE WAIVER & RELEASE
In consideration of being allowed to participate in any way in the Fury Boys Lacrosse Club which has established a recreational lacrosse club competing in the Illinois High School Lacrosse Association for male student-athletes which attend the Bremen High School District 228 member schools, namely Bremen High School, Hillcrest High School, Oak Forest High School, and Tinley Park High School and competing in other related events and activities, such as indoor lacrosse, summer leagues and/or travel teams, the undersigned parent/guardian:
1. Acknowledges and fully understands that the Fury Boys Lacrosse Club is formed independently of Bremen High School District 228 and its member schools and that neither the Fury Boys Lacrosse Club nor any of its members, players, invitees, agents, parents of players, fans or other representatives are sponsored by or affiliated with Bremen High School District 228 or its member schools.
2. Acknowledge and fully understand that my minor player(s) will be engaged in physical sporting activities that involve the risk of serious injury, including permanent disability and/or death, and severe social and economic losses which might result not only from the player(s) own actions, inactions or negligence but also the action, inaction or negligence of others, the rules of play, or the conditions of the playing and practice fields used. I further acknowledge and fully understand that there may be other risks not known to us which are not reasonably foreseeable at this time. I assume all of the foregoing risk and accept personal responsibility on behalf of my minor player(s) for the damages following any such injury, permanent disability or death as against the Fury Boys Lacrosse Club, Bremen High School District 228 and the Village of Midlothian, City of Country Club Hills, City of Oak Forest, Village of Tinley Park, and Oak Forest Park District.
3. Agree to maintain health insurance on my son(s) during the course of the 2013 season in order to cover any accidents or injuries which may occur to her during the 2012=2013 academic school year, including summer camps and/or leagues, open gyms, indoor lacrosse and on travel teams.
4. Release, waive, discharge and covenant not to sue the Fury Boys Lacrosse Club, Bremen High School District 228, its member schools, the Illinois High School Lacrosse Association and the Village of Midlothian, City of Country Club Hills, City of Oak Forest, Village of Tinley Park, and Oak Forest Park District, Illinois, their administrators, officers, directors, agents, board members coaches and others, and if applicable, owners and lessors of the premises used to conduct any practices or games of the Fury Boys Lacrosse Club, including summer league all of which are referred to hereinafter as releasee, from all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releasees or otherwise, during my minor player(s) participation in Fury Boys Lacrosse Club activities as recited hereinabove, and/or any travel teams sponsored thereby .
I/WE HAVE READ THE ABOVE WAIVER AND SIGN IT VOLUNTARILY
Name of Player: ________________________________________
Address: _______________________________________________
Name of Parent/Guardian:_________________________________
Parent/Guardian Signature: ______________________________ Date: __________________
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