| Laxtreme Lacrosse Clarington Masters Lacrosse 2007 Spring Registration |
| Please click the tab beside the Yahoo sponsor links to make the page full screen before printing Personal Information First______________________________ Last ________________________________ Address _______________________________________________________________ City ___________________________________________________________________ Postal Code _____________________________________________________________ Phone __________________________________________________________________ Email __________________________________________________________________ Age ___________ Lacrosse Experience Shot (please circle) Left Right Position (please circle) Player Goalie Years played ___________ Have you played Junior A, B Senior A, B (please circle) Yes No League Information Registration Fee $110.00 Payment method (please circle) Cash Cheque ********Please make cheques payable to Laxtreme Lacrosse ******** You can mail your registration to Laxtreme Lacrosse 3279 Highway 35 Newcastle ON L1B 1L9 Please be advised all players must wear a helmet and face mask In consideration of the acceptance of __________________________________________________________ as a participant in any program offered by Laxtreme Lacrosse also known as Clarington Masters Lacrosse and any of its subsidiaries, I the undersigned agree that participation in any of the Clarington Masters Lacrosse League programs is at the participant�s own risk. The Clarington Masters Lacrosse League shall not be held responsible for any damages arising from personal injuries sustained by the participant. The participant assumes full responsibility for any injuries or damages which may occur to the participant. The participant hereby fully and forever release and discharge by Clarington Masters Lacrosse their employees and agents, servants and signs from any claims, demands, damages, rights of action, or causes of action, present or future, where the same be known or unknown, anticipated or unanticipated, resulting from or arising out of the participation in any Clarington Masters Lacrosse League, game, practice, or activity. The Clarington Masters Lacrosse League reserves the right to use any pictures taken during the program for advertising, promotional and/or instructional purposes and the participant waives and proprietary rights he or she may have in any pictures taken or used. The undersigned hereby further consent to the Clarington Masters Lacrosse League and their employees or agents obtaining whatever medical treatment and/or care is deemed necessary by such staff for the health and well-being of the participants during the program or event, including the consent to obtain and have administered any emergency medical or surgical treatment recommended by a physician. I, the undersigned participant, hereby acknowledge that we have read the foregoing, understand its content, import, and meaning, and hereby do approve and consent to the terms and conditions stated above. I further acknowledge that the information given on this application is complete and accurate. Player Signature __________________________________________________________ Date _________________________________________ |