East Cobb Lacrosse

Consent, Release and Indemnity Agreement

We, the undersigned, for and in consideration of providing the undersigned

Player with the opportunity to participate in the Junior Greyhound Lacrosse program,

do hereby unconditionally release and agree to indemnify and hold harmless Junior Greyhound Lacrosse, Hightower Trail Middle School, the Cobb County School System, the City of Marietta, East Cobb Lacrosse, or any person, coach, volunteer or entity employed by or associated with any of them from any and all claims for personal injury, death, property damage or any type of claim or damage (including, but not limited to attorney’s fees and litigation expenses) resulting from or arising out of the undersigned Player’s participation in the sport of lacrosse or transportation to and from events with Junior Greyhound Lacrosse.

We, the undersigned, hereby consent and grant to the coaches or volunteers of Junior Greyhound Lacrosse with the express authority and discretion, but not the requirement, to provide any medical or emergency services needed by the undersigned Player during his/her participation in the sport of lacrosse with the undersigned parent/guardian being financially responsible for such services.

The undersigned represents the Player is physically and psychologically able and prepared to participate in the sport of lacrosse, and understands and accepts the fact that sports participation, including lacrosse, involves risks of injury and bodily harm, including but not limited to, paralysis and death. These risks are voluntarily and knowingly assumed by the undersigned.

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Player’s Signature Parent/Guardian’s Signature Date

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Player’s Printed Name Parent/Guardian’s Printed Name

Emergency Contact: (Other than Parents)

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NameRelationship

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Home PhoneCell Phone

Primary Medical Insurance Carrier______

Group Plan or Policy # ______

Any Medical Issues ______

(Allergies, asthmas, medications, etc.)

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Meds Player Is Required To Keep On-site? ______

PLAYER’S CODE OF CONDUCT

I, ______understand that I am expected to demonstrate sportsmanship and ethical conduct, in support of fair play and respect for the sport of lacrosse and the facility at which the game is played.

Unsportsmanlike conduct will NOT be tolerated. Any unsportsmanlike act (includes fighting, profane language, excessive physical play) could result in not being allowed to participate.

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Player’s SignatureParent/Guardian’s Signature Date

PARENT’S CODE OF CONDUCT

Because I recognize the important role that youth sports plays in the lives of young people, I pledge that I will participate in my child’s team activities in accordance with the following rules:

I will promote sportsmanship, teamwork, and a competitive spirit for players and spectators in a positive manner.

I will not question the judgment call of an official.

I will support my child’s team and coaching staff and resolve to allow the coaches to manage their team as they feel best benefits the entire team.

Because I am a role model for my child as well as others, my personal conduct at games, practices and other team events must be above reproach and representative of the highest standards of morality and sportsmanship. Therefore, I pledge that:

At games and practices, I will exhibit exemplary behavior for players, other parents, and spectators.

I will at all times be in control of my emotions and will be considerate of my team’s collective emotions.

I will not make disparaging remarks of any type with regard to officials, players, coaches, opposing team members or coaches, or publicly criticize or demean them in the course of any event.

I accept these rules and agree to conduct myself according to their principles and to the regulations of Jr. Greyhound Lacrosse. I understand that I may be removed from any event for failure to abide by these rules.

Signature of Parent/Legal Guardian: ______Date ______

PHOTO RELEASE

Junior Greyhound Lacrosse has my permission to include photos of my child,

______on their website, jrgreyhoundlax.com.

Signature of Parent/Legal Guardian: ______Date ______

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