Player Registration Form

 

 
  Returning Player  
Player Name:*  
Parent Name:*  
Parent Email:*
Note: Each registration at a given grade level requires a unique email address. You can use the same email address for registering players of different grade levels, but if two players are both in high school, or 7/8, etc. you will need to provide a unique email address for each.  For example, you might use work vs. personal email, a spouse's email, etc.

 

  
US Lacrosse Member No:
If the registrant has a US Lacrosse membership, please provide the membership number for our records. Many tournaments our teams participate in require a US Lacrosse membership due to the insurance coverage it provides.  US Lacrosse members also receive a number of other benefits.

Review US Lacrosse membership benefits and obtain a current membership number.
 
Birth Date:*   (mm-dd-yyyy)  
Grade:*
 		  
Address 1:*  
Address 2:  
City, State,
Zip Code:*
 		 ,       
School:*  
Height/Weight:*    (e.g., 5'10" / 140)  
Home Phone:*  
Cell Phone:
 		  
  Financial Assistance may be available to assist families who are experiencing financial hardship. If you need to apply for financial assistance, please check this box and a board member will contact you.  
     

PLAYER/PARENT ACKNOWLEDGEMENTS

  
The following acknowledgements are required to complete registration. Copies of the referenced documents will be emailed to each registrant in confirmation of their registration and must be signed and delivered to Eastlake Lacrosse before a player will be allowed to practice or participate in a game. Mailing instructions are included in the confirmation email. Links to the documents are also provided below.
 
Code of
Conduct*
 I, the applicant/athlete have read and will abide by the Players Code of Conduct for my age group. I also understand that a signed copy of the Code of Conduct will be required before I am allowed to practice or play.
 
Review a copy of the Parent Code of Conduct
LWSD Athletic/Activities Drug, Alcohol & Tobacco Code*
  I, the applicant/athlete certify that I have read and understand and will abide by the LWSD Athletic Code.
 

  I/We, the parent(s) or guardian(s) of the applicant/athlete certify that I/we have read and understand the LWSD Athletic Code.
 
Review a copy of the LWSD Athletic Code
     

WAIVERS AND ACKNOWLEDGEMENTS
 

PARTICIPATION

I/We, the parent(s) or guardian(s) of the above named athlete to Eastlake Lacrosse Club, (which shall refer to and include the Lake Washington Lacrosse Association, The Eastlake Lacrosse Association and any related entities) hereby give my/our approval to said applicant's participation in any and all Eastlake Lacrosse Club activities from the date on which this form is signed until one year thereafter (the "current season"). I/We will furnish a certified birth certificate of the applicant upon request of Eastlake Lacrosse Club. I/We agree to be financially responsible for Eastlake Lacrosse Club equipment or uniform issued to the applicant other than normal wear and tear or breakage that may occur during practice and games. I/We will reimburse Eastlake Lacrosse Club the retail replacement cost for the loss and or damage of said equipment or uniform. I/We certify, that to the best of my/our knowledge, all of the above information is accurate and correct and that any false information may be cause to disqualify the applicant. I/We consent to use of the applicant/athlete's photo on the Eastlake Lacrosse website and to publication of the applicant/athlete's name in local newspapers in connection with the reporting of game results.

 

WAIVER, ACKNOWLEDGMENT AND ASSUMPTION OF RISK

I/We are fully aware of, appreciate, and voluntarily accept the risks, including the risks of catastrophic injury, paralysis and even death, as well as other damages and losses, associated with participation in any and all Eastlake Lacrosse Club (which shall refer to and include the Lake Washington Lacrosse Association, The Eastlake Lacrosse Association and any related entities) activities from the date on which this form is signed until one year hereafter (the “current season”) during the current season, including but not limited to lacrosse practices and games (“lacrosse event”), and transportation to and from the activities. I/We confirm that the above applicant/athlete is fully aware of, appreciates, and voluntarily accepts such risks. I/We understand that participating in a lacrosse event may be an extremely strenuous activity and confirm that the above applicant is physically and mentally capable of participating in a lacrosse event. As lawful consideration for being permitted to participate in Eastlake Lacrosse Club activities, I/We on behalf of myself/ourselves, the above applicant, and our heirs and personal representatives, hereby waive, release, absolve, indemnify and hold harmless Eastlake Lacrosse Club, its officers, directors, employees, agents, volunteers, sponsors, supervisors, participants and any person transporting the applicant, from liability for any injury, loss of life or any other losses or damages arising out of or related to the above applicant's participation in any and all Eastlake Lacrosse Club activities during the current season.
 
  Parent / Guardian 1
 		 Parent / Guardian 2
 

I/We, the parent(s) of the applicant/athlete agree to the above waivers*
 

Initials of parent(s)/legal guardian(s) of minor under 18 years of age or legal guardian of
incapacitated and/or mentally challenged person or athlete over 18 years of age*
 
   

 

  
 
Signed by Applicant/Athlete (type full name to sign and acknowledge this registration form)
 		  
 
Signed by Parent/Guardian (type full name to sign and acknowledge this registration form)