Bay Area Youth Sports Foundation

BAYS Free Youth Lacrosse Clinic 2011

Any 1st-8th grade boy with a ticket for the 2011 San Francisco Fall Lacrosse Classic is eligible to be registered for a free lacrosse clinic under the direction of the coaches and student-athletes from University of Denver and Harvard University by a parent/legal guardian. Upon submission of this form, registrants will be entered into a random lottery to determine the participants at the clinic. Selected participants will be notified via the parent/guardian email address provided below no later than September 25, 2011. Limited to one entry per child. Multiple registrations for the same child are not permitted. You must purchase a ticket to be eligible for a spot in the clinic lottery.

Registrant's Name * First Last
Please enter the registrant's name.
Registrant's Date of Birth * MM / DD / YYYY
Please enter the registrant's date of birth.
Registrant's Grade (as of October 2011) *
First Grade Second Grade Third Grade Fourth Grade Fifth Grade Sixth Grade Seventh Grade Eighth Grade

Please enter the registrant's grade in school as of October 2011.
Registrant's Lacrosse Program/Team *

Please enter the team or youth program in which the registrant participates.
Registrant's Playing Experience *
Beginner 1-2 years 2-3 years 3-4 years More than 4 years

Please select the registrant's lacrosse experience.
Lacrosse Experience and Interests

Please provide any other comments regarding the registrant's playing experience. Feel free to also provide information about what aspects of lacrosse interest the registrant most.
Position(s)
Attack/Midfield Defense Goalie Do Not Know
Parent/Guardian Name * First Last
Please enter the contact information for the parent/guardian responsible for the registrant. This information will be used in case of emergency on the day of the event.
Parent/Guardian Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please enter the contact information for the parent/guardian responsible for the registrant. This information will be used in case of emergency on the day of the event.
Parent/Guardian Phone Number * ### - ### - ####
Please enter the contact information for the parent/guardian responsible for the registrant. This information will be used in case of emergency on the day of the event.
Parent/Guardian Mobile Phone * ### - ### - ####
Please enter the contact information for the parent/guardian responsible for the registrant. This information will be used in case of emergency on the day of the event.
Parent/Guardian Email *

Please enter the parent/guardian's email address. Selected participants will be notified at this email address by October 1, 2010.
US Lacrosse Membership #

Please enter your US Lacrosse Membership #.
Free Youth Lacrosse Clinic - Waiver of Liability, Assumption of Risk and Indemnity Agreement

Waiver: In consideration of being permitted to participate in any way in the Bay Area Youth Sports Foundation ("BAYS") Free Lacrosse Clinic ("Clinic") held on October 8, 2011 at Kezar Stadium in San Francisco, California that I have enrolled my child in, as listed on the Registration Form (“Clinic Participant”), I, for myself, my heirs, Clinic Participant, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue The Bay Area Youth Sports Foundation ("BAYS"), University of Denver, Harvard University, The City and County of San Francisco, Kezar Stadium, NCAA, All West Lacrosse and their respective officers, directors, employees, Clinic staff, coaches, players, employees and agents (collectively "Indemnified Parties") from liability from any and all claims including negligence of the Indemnified Parties, resulting in personal injury, accidents or illness (including death), and property loss arising from, but not limited to, participation in the Clinic.

Assumption of Risk: Participation in the Clinic carries with it certain inherent risks that can not be eliminated regardless of the care taken to avoid injuries. I am aware and familiar with the many ordinary and hazardous risks involved in lacrosse including, but not limited to, travel to and from the site of the Clinic, physical contact, and the possible reckless conduct of other participants. I also understand the dangers of participating in the Clinic and related activities include, but are not limited to, 1) minor injuries such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions 3) catastrophic injuries including paralysis and death.

I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the Clinic. I hereby assert that the Clinic Participant’s participation is voluntary and that I knowingly assume such risks. I understand on behalf of myself and the Clinic Participant that I am assuming these risks.

Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD the Indemnified Parties from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in the Clinic and to reimburse the Indemnified Parties for any such expenses incurred.

Medical Treatment: I authorize the Clinic staff to act for me in securing medical treatment for the Clinic Participant in the event of injury or sickness.

Severability: The undersigned further expressly agrees that the forgoing Waiver of Liability, Assumption of Risks and Indemnity Agreement is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

Acknowledgement of Understanding: I have read this Waiver of Liability, Assumption of Risk and Indemnity Agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the Agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law. I further grant permission for BAYS to photograph and/or video tape the Clinic Participant during the Clinic and to use his name and/or likeness relating to his participation in this Clinic in future promotion of similar event. I also waive all rights to any future compensation to which I or the Clinic Participant may otherwise be entitled to as a result of the use of the Clinic Participant’s name or likeness. *
I accept this release. I reject this release.

Parent/Guardian, please read the following Waiver and select whether you accept or reject the release. By selecting "I accept this release", you acknowledge that you have read the text in its entirety and agree to the terms described. By selecting "I reject this release", your child will not be allowed to participate in the clinic.
Signature of Parent/Guardian of Minor *

Parent/Guardian, please write your electronic signature after accepting or rejecting the release.
Date * MM / DD / YYYY
Parent/Guardian, please write today's date after signing with your electronic signature.
Do Not Fill This Out