Capt Cup Lacrosse

Player Information

Player Name

First Name Last Name

Team

Birth Date

Month Day Year

Grade

Gender

Male Female

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Parent/Guardian Information

Name

First Name Last Name

Home Number

Area Code Phone Number

Cell Number

Area Code Phone Number

E-mail

Emergency Information

Emergency Contact's Name

First Name Last Name

Relationship

Phone Number

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Thayer Sports Center during the Captians Cup Lacrosse League. In exchange for the acceptance of said child’s candidacy by Thayer Sports Center., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Thayer Sports Center. and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected league sessions.

In case of injury to said child, I hereby waive all claims against Thayer Sports Center. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including basketball. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

BY SIGNING THIS DOCUMENT YOU MAY BE WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE

ASSUMPTION OF RISK: I am aware that indoor lacrosse involves certain inherent risks, dangers and hazards which can result in serious personal injury or death. I am also aware that the field house at Thayer Sports Center contains potential dangers to the users. As such, I hereby freely agree to assume and accept any and all known and unknown risks of injury while participation in indoor sports activities. I further recognize and acknowledge that the risks inherent in indoor lacrosse can be greatly reduced by: abiding by the Turf Responsibility Code (now known as ‘Your Responsibility Code’) and using common sense.

RELEASE AND WAIVER OF CLAIMS AGREEMENT: In consideration of allowing me to participate in the above turf activities at the Thayer Sports Center, I hereby agree as follows:

TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the Thayer Sports Center and/or the League resulting from the League’s activities at the Thayer Sports Center which arise out of or relate to my participation in turf activities; the League’s activities at the Thayer Sports Center and/or the operation, supervision, design or maintenance of the Thayer Sports Center.

TO THE FULLEST EXTENT PERMITTED BY LAW TO RELEASE both the Thayer Sports Center and the management company, including all of their respective agents, servants and employees, from any and all liability for any loss, damage, injury or expense that I may suffer, or that my next of kin may suffer, as a result of my participation in the activity described in this Agreement which is caused in whole or in part by the negligence and/or breach of contract on the part of the Thayer Sports Center, the League or their respective agents, servants or employees including, but not limited to, alleged acts or omissions arising out of or relating to the operation, supervision, design, or maintenance of the Thayer Sports Center.

INDEMNIFICATION: I agree to indemnify and hold the Thayer Sports Center/League harmless from any and all claims, loss or damages caused in whole or in part by my own negligent acts or omissions.

ENTIRE AGREEMENT: In entering into this Agreement, I am not relying upon any oral or written representation other than what is set forth in this Agreement. To the extent that any provision of this Agreement is deemed to be void or unenforceable, the remaining provisions contained herein shall survive.

I ACKNOWLEDGE THAT I AM 18 YEARS OF AGE OR OLDER, HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature

Clear

My Products

Boys Indivdual Registartion $ 175.00

Girls Indivdual Registartion $ 175.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Captian's Cup participation fees are non-refundable. In exceptional circumstances Thayer Sports Center Management may, at it's sole and absolute discretion, approve a full or partial refund. Thayer Sports Center Management is under no obligation to approve a refund. All requests for refunds must be submitted in writing to Thayer Sports Center Management.

Thayer Sports Center Management will approve a prorated refund if the request is made because of an injury to the player that, in the written opinion of a medical doctor, prohibits the player from participating in Lacrosse for a period of at least 8 weeks. Refunds in this case will be made within 30 days of Board approval.
The Board will approve a prorated refund if the request is made because the player and his/her family are moving from the area (over 75 miles) during the lacrosse season. Refunds in this case will be made within 30 days of Board approval.

All other refund requests for reasons other than those stated above will be reviewed by Thayer Sports Center Management on an individual basis.

Captains Cup