WAIVER, RELEASE OF LIABILITY, MEDICAL AUTHORIZATION & CONSENT TO TREAT
In consideration of each player’s participation in the sponsored activities of the Jackson Hole Lacrosse Club (“JHLC”), the below described player and parent/guardian acknowledge and agree to the following:
WAIVER & RELEASE OF LIABILITY. The below described player and parent/guardian are fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages and losses, associated with the below described player’s participation in lacrosse. The below described player voluntarily agrees to participate in the JHLC program. The below described player and his/her parent/guardian and their heirs and representatives, hereby waive, release, and forever hold harmless JHLC and the sponsors of any JHLC sanctioned event, along with the past, present, and future coaches, volunteers, employees, agents, officers and directors of the foregoing organizations, from any and all liability for damages and claims for damages for personal injury, including accidental death, as well as from claims for property damage, and from any other liability, rights, claims, demands, damages, costs, expenses, actions, causes of action, suits of liability and controversies, known or unknown, foreseen or unforeseen, arising out of or in any way related to JHLC programs and/or equipment provided. Furthermore, this waiver and release of liability applies in the event of personal injury, including accidental death, as well as from claims for property damage, and from any other liability that occurs as a result of player voluntarily leaving the location of any JHLC event, including practices or games.
READINESS TO COMPETE. The below described player will only participate in those Jackson Hole Lacrosse Club events and competitions for which such player believes he/she is physically and psychologically prepared to compete.
CODE OF CONDUCT. The below described player has read and agrees to all terms in the Jackson Hole Lacrosse Club Code of Conduct, especially with regard to his/her responsibilities as a player.
MEDICAL AUTHORIZATION AND CONSENT TO TREAT. I (adult player/ parent/ guardian), hereby grant my authorization and consent for the Jackson Hole Lacrosse Club and its coaches, volunteers, employees, agents, officers and directors to obtain medical care and/or administer general first aid treatment for any injuries or illnesses experienced by the foregoing described player in the course of participation in, or attendance at, JHLC events, including practices and games. If the injury or illness is life-threatening or in need of immediate or emergency treatment, I authorize JHLC and its coaches, volunteers, employees, agents, officers and directors to summon any and all professional personnel (including emergency personnel) to attend, transport, and treat the foregoing described player and to issue consent for any X-ray, anesthetic, blood transfusion, medication, or other medical diagnosis, treatment, or hospital care deemed advisable by, and to be rendered under the general supervision of, any licensed physician, surgeon, dentist, hospital, clinic or other medical professional or institution duly licensed to practice in the state in which treatment is to occur. I agree to assume financial responsibility for all expenses of such care.
I hereby certify that, as the parent/guardian of the foregoing described player, I have legal responsibility for and authority to sign this WAIVER OF LIABILITY, MEDICAL AUTHORIZATION & CONSENT TO TREAT on behalf of the foregoing described player. I further certify that I have read this WAIVER OF LIABILITY, MEDICAL AUTHORIZATION & CONSENT TO TREAT in full, understand the same and have signed it voluntarily and without any duress or coercion.
PHOTO AUTHORIZATION. Photos and video taken of below described participant while participating at the Jackson Hole Lacrosse Club games, practice, or events may be used in and for any JHLC publications, advertisements, or social media.
EMERGENCY MEDICAL PLAN. In the event of an injury that requires medical attention outside the scope of the coach (i.e. bandaid, ice, etc.), the parents will be notified, and if necessary the player will be transported to the hospital or urgent care facility by a coach, team manager, or JHLC staff member.
In the event of an injury/emergency that which is life-threatening or requires the player to be stabilized, notably any potential neck injury, the coach or team manager will call 911 to arrange for emergency medical services.
In any medical emergency, the coach or team manager will contact the parents of the affected player at the primary phone number listed and all emergency contacts listed on the Medical Waiver and explain the injury/emergency.
Today's Date: August 26, 2019