I or I and my minor child (hereafter “Applicant”) hereby applies for participation as a player or parent of a player in any Blackwolf Lacrosse INC sponsored event and I/we agree that: 1. Guaranteed participation is dependent upon receipt of Applicant’s completed application and fee before the start date of any clinic or camp. No refunds or pro-rated refunds will be issued for any camp, clinic or lesson once it has begun including but not limited to sickness, injury or inability to participate in the program due to scheduling conflicts. 2. All equipment required by the National Federation of State High School Associations must be furnished by and worn by the player including a PROTECTIVE MOUTHPIECE. 3. Blackwolf Lacrosse INC and Joseph Trigiani, its Officers, Directors, Agents, Coaches, Staff and Officials shall be indemnified and held harmless by Applicant and his/her heirs, representatives and assigns, from and against any suit, claim or other action for personal injury or injury to property which Applicant may sustain from participation in any practice or game or which otherwise may arise out of Applicant’s participation in this event; In connection with the Applicant’s participation in ANY Blackwolf Lacrosse INC event, the undersigned do certify that the Applicant/player is in good health, has no physical impairment restricting him from playing lacrosse, except as herewith provided in writing to Blackwolf Lacrosse INC, and otherwise is able to participate in the program activities. We (are, are not) attaching a statement explaining special physical limitations and/or required medication, if any, (please indicate if the Applicant/player suffers from allergies, asthma, diabetes, restricted activities, etc.). In further consideration of Blackwolf Lacrosse INC and Joseph Trigiani, acceptance of this application, the undersigned, both for himself or herself and on behalf of any minor child for whom he or she is submitting this application, hereby agree(s) to indemnify and hold harmless, Blackwolf Lacrosse INC and Joseph Trigiani, its officers, directors, coaches, staff, workers, volunteers, agents, and sponsors from and against any and all liability, claims, actions, lawsuits, losses, judgments, and demands whatsoever, in law or in equity, arising out of or in any way relating to the Applicant’s participation in any Blackwolf Lacrosse event, including, but not limited to, personal injuries or injury to property sustained or caused by the Applicant during or as a result of participation by the Applicant in a Blackwolf Lacrosse INC event. The Applicant and/or parent or guardian is aware of the fact that lacrosse is a physically demanding and challenging sport in which serious injuries and death may occur.

 By checking this box, we hereby authorize Blackwolf Lacrosse INC and its agents to request medical assistance and to authorize medical treatment for and on behalf of the Applicant as deemed reasonable and necessary by an appropriate medical professional to protect the well being of the Applicant. I affirm that I / We have read, understand and agree to the conditions set forth and certify that the information that I / We have provided is correct.