JSSLL 2010
Men’s League Application
Name ___________________________Position(s)_____ DOB___/___/___
Address______________________ City_______ State ____ZIP________
Phone (Home)_______________Work ___________Fax_______________
Email _______________________________________________________
School/Club play(ed) on _______________________Yrs experience______
Have you played in this league before? ____Yes ____No
If yes when__________________ What team? ____________________________
U S Lacrosse member? # if Yes________ No __________________________________________________________________
League site: The National Guard Training Center, Sea Girt, NJ
League Dates: Sundays June 6 - July 25
Game times 11am - 2pm
Registration:
1. By mail , phone or first day at field Sunday June 6
League Fee:
____Individual $130.00
____Team $2500.00 ( If registering a team attach roster with this application filled out by team captain)
Teams : Players will be assigned to teams according to info on this form. Arrangements can be made for those who travel together.
Roster size will not exceed 25
Send check or money order to:
Jersey Shore Summer Lacrosse League
388 Harper Avenue, Brick, NJ 08724
Players will not be permitted to participate without the following signed AMATEUR ATHELETIC MINOR WAIVER AND RELEASE OF LIABILITY
In consideration of being allowed to participate in any way in the Jersey Shore Summer Lacrosse League, the undersigned:
1. Agree that the participant will prior to participation inspect the facilities and equipment to be used, and if the participant believes anything unsafe, he or she should immediately advise the 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 actions, inactions or negligence of others, the rules of play, 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 risk and accept personal responsibility for the damages following such injury, permanent disability or death.
4. Release, waive, discharge and covenanant not sue Jersey Shore Lacrosse and it’s affiliated clubs, their rrespective administrators, directors, agents, coaches and other employees of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leassors of premisesused to conduct the event, all of which are hereinafter referred to as “releasees”, from any and all liability to each of the undersigned, his or her heirs and the next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused in whole or in part by the negligence of the releasees or otherwise.
I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I/WE GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.
Institute/ organization: Jersey Shore Lacrosse
Print Participant’s Name:___________________________
Signed:___________________________Date:_________
Parent/Guardian if Minor Sign:_______________________
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