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CLINICS & CAMPS
2020 GOALIE/SHOOTING CLINIC
2020 GOALIE/SHOOTING CLINIC
Please complete the form below and click 'Submit' to proceed to the PayPal payment screen.
Please note: You must fill in all fields and checkboxes with a
red asterick *
Clinic you are registering for
August 5th and 7th, Old Redskin Park, Herndon VA 20171
Location: Old Redskin Park, 13832 Redskin Drive, Herndon VA 20171
HS Attending (If Known)
HS Graduation Year
State / Province / Region
ZIP / Postal Code
US Lacrosse membership number
US Lacrosse membership expiration
Date Format: MM slash DD slash YYYY
Check to accept participation waiver
I accept the participation waiver
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 camp, clinic, 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. The parent/guardian will be responsible for providing a statement explaining and and all 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.
Check to authorize medical treatment
I authorize medical treatment
The undersigned hereby authorizes 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.
Check to accept refund policy
I accept the no refund policy
2019 U15 Summer Camp Registration
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