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2020 Fall Kindergarten through 2nd Grade CLINIC Register HERE

PLAYER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION


MEDICAL WAIVERS

Assumption of the Risk and Waiver of Liability Relating to Coronavirus / COVID-19


By accepting this Assumption of Risk and Waiver of Liability, I acknowledge that I have read and recognize the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and myself may be exposed to or infected by COVID-19 by attending an activity organized by Lady Dragon Lacrosse and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the training/camp may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Lady Dragon Lacrosse employees, volunteers, and program participants and their families. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the training/camp or participation in Lady Dragon Lacrosse programming (“Claims”). I have read and understand the information that is included in the Governors Open Texas Report regarding the guidelines of social distancing and the additional protocols that has been provided by Lady Dragon Lacrosse. On my behalf, and on behalf of my children, I hereby release, covenant not to sue, discharge, and hold harmless Lady Dragon Lacrosse, its Board of Directors, employees, coaches, agents, volunteers and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Lady Dragon Lacrosse, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Lady Dragon Lacrosse program. I further understand that a confirmation of acceptance of this waiver must be provided to Lady Dragon Lacrosse upon arrival to the training facility before the player will be allowed to participate.

Student Athlete Medical Waiver and Consent to Treat


I, the undersigned parent, hereby grant the LDL (representative) of Lady Dragon Lacrosse, the authority to obtain medical treatment for my child. The above care provider(s) shall have the authorization to:



  • Obtain medical treatment and procedures for the child as may be appropriate in emergency circumstances, including treatment by physicians, hospital, clinic personnel, and other health care providers.

  • Obtain routine medical treatment from appropriate health care providers if symptoms of illness (e.g., fever, coughing, irregular breathing, unusual rashes, swallowing problems, etc.) occur.


The grant of temporary authority shall begin on the day this registration is submitted and will remain in effect until the final game of the season, including playoffs, or the End of the Year Banquet, whichever is the later.


In case of emergency, the care provider(s) should first try to contact the parent(s) listed at time of registration. If parents cannot be reached, the care provider should refer to the registration information section Emergency Contact and Medical Information for the next listed contacts as well as the physician and insurance information.

 

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