Hawks - 2019 Little Rhody Fall 100 Registration

HAWKS: LITTLE RHODY FALL 100 - REGISTRATION

* Indicates required field

Participant Name *

First

Last

Position *

Class Year (Fall '19) *

Hawks Jersey Number *

Player Email *

Player Contact Number (For Text Alerts) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Parent(s) Name *

Parent Email *

High School Coach *

High School Coach Email *

Insurance Carrier *

Insurance Policy Number *

Participant Health Issues *

Emergency Contact *

Emergency Contact Phone *

LIABILITY WAIVER
I represent that I am the parent and/or legal guardian of the child named below and hereby give my permission for my child to participate in any and all activities at the 2019 Little Rhody Fall 100 Showcase "Showcase" at Roger Williams University "University". I agree to assume all risks associated with my child's participation in the Showcase including but not limited to, risk of bodily injury, death, and / or property damage. In consideration of my child being permitted to participate in the Showcase, I agree to release, indemnify, and hold harmless the University & Little Rhody Lacrosse, LLC, its trustees, directors, officers, employees, students, contractors, volunteers, affiliates, and agents, from any and all claims that I or any third party might have as a result of my child's participation in the Showcase. I give my consent for my child to receive emergency medical treatment in the event that my child becomes ill or is involved in an accident during the Showcase. I understand that I will be notified at the emergency telephone number provided on this form in the event of an emergency involving my child.

Waiver Approved By *

SUBMIT