Cocalico Care Center
659 South 4th St. Denver | PA
Serving Denver • Reinholds • Stevens • Adamstown • Schoeneck
Print the following forms and complete for registration.
Waiver of Liability, Release, Assumption of risk & Indemnifying Agreement.
For in consideration of participant's registration with Cocalico Boys Lacrosse Club and being allowed to participate in Cocalico Boys Lacrosse Club events and activities, the parent(s) or legal guardian(s) of participants relinquish and all liability for and cause of action for personal injury property damage or wrongful death occurring to participant arising out of participation in Cocalico Lacrosse events or activities or the sport of lacrosse, or and activities may continue and bye this agreement any such claims, rights and causes of action that participant may have are hereby relinquished and the participants (or parent(s)/guardian(s) does (do) so on behalf or my/our and participant's heirs, executors, administrators and assigns. Participant and/or participant's parent(s)/guardian(s) acknowledge, understand and assume all risks, if any, arising inherent in lacrosse and any activities, and understand that said sport and activities involve risk to participant's person including bodily injury, partial or total disability, paralysis and death, and damages, which may arise there from and that I/we have full knowledge of said risks. These risks and dangers may be caused by negligence of the participant or the negligence of others, including the "releasees" identified below. It is further acknowledged that there may be risks and dangers not known to us or are not reasonably foreseeable at this time. Participant and/or participant(s)/guardians(s) acknowledge, understand and assume the risks, if any, arising from the conditions and use of lacrosse fields and related premises and acknowledges and understands that included within the scope of this waiver and release is any cause of action, arising from the performance, or failure to perform maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said fields, for negligent selection of certain releases, or negligent supervision or instruction by releases. It is the purpose of this agreement to exempt, waive, and relieve releases from liability for personal injury, property damage, and wrongful death caused by negligence, including the participants, coaches, officials, sponsors, advertisers, owners and operators of the premises used to conduct any event and each of them, their officers, directors, agents and employees. Participant or participant's parent(s)/guardian(s) agree if any claim for participant's personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless releases from any and all claims or causes of action by whomever or wherever made or presented for participant's parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they fully advised of the potential dangers of lacrosse and understand these waivers and releasees to allow amateur lacrosse exist in its present form.
If you consent to this Waiver of Liability, Release Assumption of risk & Indemnifying Agreement. Select the option below as your signature on this date. You may then continue to the Registration Form.
Cocalico Boys Lacrosse Club • Denver, PA • email@example.com
Cocalico Care Center / (717) 336-4007 / 659 South 4th St, Denver, PA 17517