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CLICK HERE 2024 MCSA Summer Clinic Series Registration

PLAYER INFORMATION
PARENT(S)/GUARDIAN(S)

MEDICAL/EMERGENCY CONTACT INFORMATION

WAIVER INFORMATION
"In registering my child in MCSA, I understand that the rules of MCSA, participation of a parent or guardian in some form is required. I also understand that it is my responsibility to notify MCSA of any disability or impairment that may hinder the full participation of my child in the program. Furthermore, I understand that in the event of an accident or injury sustained by my child, that MCSA is responsible to the extent of their insurance coverage. I furthermore understand that if a child or parent, through his/her own conduct, violate any of the rules of MCSA, that child or parent is subject to suspension, and the registration fee or any part thereof is non-refundable. I also understand that I/we will read and understand the concussion policy of MCSA.

I also:
1) Agree that the participant should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she should immediately advise hisor her coach or supervisor of such condition(s) and refuse to participate.
2) Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction, and negligence of others, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
3) Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
4) Release, waive, discharge and covenant not to sue N.Y.A.S.A. / MCSA (Middle Country Sports Association) its affiliated clubs, their respective administrators, directors, agents, and other employees of the organization, other members/participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors or premises used to conduct the event, all of which are hereinafter referred to as “releases,” from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.
When registering online by clicking the register online button, you agree to these terms."

Payment by mail: send completed form with check to MCSA 4 Bonnie Road, Centereach, NY 11720

Registration will not be complete until payment is made. Child will not be allowed to participate until completely paid.
 

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