06/21 Summer Kickoff 619 Positional Training AFTERNOON CLINIC Registration

LIABILITY WAIVER(required)

By proceeding with registration, I hereby request that the child named above herein be admitted to the 619 Lacrosse Camp and give my permission for him/her to participate in the camp training regimen which I realize as a physical activity can result in injury. I hereby waive all claims to liability to the directors, coaches, staff, and Camp/Facilities Organizer (619 Lacrosse) and authorize the directors to act for me according to their best judgments in any emergency requiring medical attention for services other than the accident insurance maintained by the camp, I will pay. All camp insurance policies must be followed exactly in order to receive coverage.

Understanding of usages of Facilities – 1(required)

By proceeding with registration, I acknowledge that my family will adhere to the San Diego Safe Reopening as dictated by San Diego County's Health Department. I will adhere to the rules, and regulations as laid out by the Facility holder (San Diego Unified School District)

Understanding of usages of Facilities – 2(required)

I acknowledge that I am participating in a hosted event that is required to adhere to all San Diego Unified School District's updated Mask Policy as dictated by San Diego Unified School District's Nursing and Wellness Department.

Understanding of 619Lacrosse COVID Protocols(required)

I acknowledge that I am participating in a hosted event that is required to adhere to all San Diego Unified School District's updated COVID-19 Policies as dictated by San Diego Unified School District's Nursing and Wellness Department. Athletes and guests may be asked to produce a COVID-19 Vaccination Card as required as part of the Event Guest (619Lacrosse.com) rental agreement with the San Diego Unified School District.

PHOTOGRAPHS/VIDEOS/SOCIAL MEDIA WAIVER

I hereby further authorize 619 Lacrosse Camp to take photographs and videotape my child while participating in any 619 Lacrosse activities. By checking this box, I authorize 619 Lacrosse.com to use any of the above for promotional purposes and promotional purposes only.

ASSUMPTION OF RISK:(required)

In exchange for the right for the Player to participate in the 619 Lacrosse Programs, I hereby assume all risks associated with lacrosse, including the RISK OF SERIOUS BODILY INJURY, DEATH and/or PROPERTY DAMAGE and the negligence of 619 Lacrosse, and Ihereby agree NOT TO SUE 619 Lacrosse, nor their sponsors, directors, officers, employees, coaches, volunteers, instructors, agents, partners, sponsors, nor any of their affiliates (“619 Lacrosse Parties”) and I release the 619 Lacrosse Parties from any and all liability, claims or demands of every kind and nature whatsoever which may arise out of the Player’s participation in activities arranged by 619 Lacrosse. I agree NOT TO SUE and I release the 619 Lacrosse Parties and fully accept the risk of any illness or injury suffered by the Player while taking part in the 619 Lacrosse Programs (including injuries that might cause death), including the ones listed above and other injuries common to contact sports and injuries (including injuries that might cause death) that may arise during travel associated with the 619 Lacrosse Programs. I release the 619 Lacrosse Parties and fully accept the risk of any damage to property arising out of the 619 Lacrosse Programs. This release will serve as a release and assumption of risk which binds my heirs, executors, and administrators, and for all members of my family

PARENTAL/GUARDIAN CONSENT:(required)

As parent/guardian, I give my child permission to participate in the 619 Lacrosse Camp programs and activities and I release 619Lacrosse.com, employees or agents, from any responsibility and or liability regarding any injury resulting from participating in any and all of the programs 619 Lacrosse offer. I further agree to inform my child that he/she must follow all safety rules, policies, and procedures as instructed with regard to the 619Lacrosse.com programs he/she is now attending or will attend in the future. By signing this form, I acknowledge that I have read and understand its contents and voluntarily choose to permit my child to participate in the activities described above.

06/21 Summer Kickoff 619 Positional Training AFTERNOON CLINIC Registration

Register Here to Join Us on The Afternoon of June 21st!

Spots are limited, so be sure to sign up ASAP to reserve your spot now!

Player Information

Parent/Guardian Information

Additional Player Information

Player Medical Information

Important Waiver Information

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