Girls Laxlife Camp Registration

Featuring Brandon Sanderson, Alexis Deaken, Avery Teeple, Callon Williams, Sarah Kee, Zoey Kruger & Lexie Delisie

Player Profile

Name *

First

Last *

Last

Address

City *

Province *

Postal Code *

Lives with: *

Primary Guardian

Birthdate *

Height *

Weight *

Years of Experience *

Are You A Goalie? *

Yes

Shoots *

Left

Right

Both

Minor Lacrosse Association *

School

Medical Information

Medical Alert *

If none, note N/A

Family Doctor *

Name

Phone # *

Doctor's Office

Health Questions

Have you ever been diagnosed with a heart condition and been told that your physical activity should be regulated by a doctor? *

Yes

When you do physical activity do you feel chest pains? *

Yes

Have you had chest pain in the last month when you were doing physical activity? *

Yes

Have you ever felt dizziness, lost consciousness or had poor balance? *

Yes

Do you have previous problems with bones or joints that would be worsened during physical activity? *

Yes

Are you taking any prescription medication for blood pressure or a heart condition? *

Yes

Are you aware of ANY OTHER REASON why you should not participate in physical activity? *

Yes

Do you have any life threatening anaphylactic allergies? *

Yes

If so, please give us more information in the drop-down section below.

PLEASE NOTE: If your answer is YES to one or more of the above questions, you will need to contact your doctor and receive authorization BEFORE being admitted into any Laxlife lacrosse camps

Allergy Information

Optional: Fill out if necessary.

Emergency Contact

Primary Legal Guardian

Name *

First

Last *

Last

Relationship *

Pick Up Authorization *

Confirm

Address

City *

Province *

Postal Code *

Mobile Phone *

Other *

Email Address *

May we email you Laxlife notices and program information? *

Yes

Secondary Contact

Optional: Fill out if necessary.

FACILITY SAFETY POLICY

For your Safety and to Protect our Facilities, Laxlife Lacrosse Camps are SMOKE FREE on all premises!
Fighting, use of abusive language, being disrespectful to other campers, camp staff, or damaging facility property is unacceptable and may result in dismissal from the facility.
Drugs or alcohol in the facility or, on the grounds are strictly forbidden. Staff reserves the right to search bags for alcohol and drugs and to deny access to anyone who appears to be under the influence.
For health and safety reasons, no animals (except guide/aid animals) should be in the Facility.
Food or drink (except water in a closed container) should not be taken onto the floor at any time. Please clean up after yourself and dispose of waste properly.
Gum should be disposed of in the proper waste receptacles.
Photography or recording devices (including cell phones with camera and recording capability) are NOT permitted, except where authorized.
To protect yourself and our equipment please wear: athletic shoes with clean, rubber soles and cleats (no metal cleats) for the Field, and; appropriate workout wear; T-shirts, long sleeve shirts, shorts of appropriate length, athletic pants/leggings. Please, do not wear: string/ cut off/mesh tank tops, jeans, street clothing, and anything displaying inappropriate slogans or offensive text or images; cleated shoes inside the building or; perfume, cologne, body spray, or hairspray.
Please do not bring your gym bags and valuables outside of locker room areas. Laxlife is not responsible for lost or stolen items; please leave valuables at home. Lost and found articles are donated to a local charity if not claimed within 7 days. Personal items (i.e. razors, hairbrushes) are disposed of for hygienic reasons.
We recommend that you stay for the entire day in order to benefit from a proper cool-down.
Only those with appropriate supervision, attire and ID, will be permitted access to the workout and training areas.
It is the campers responsibility to wear his/her helmet at all times during drills, practices, scrimmages and games.
Avoid injury when lifting weights: Before starting, warm-up properly, secure collars and check the equipment. Use proper body position and breathing technique. Use of spotters is recommended for all lifting. Return free weights and dumbbells to the appropriate racks when finished.
Unsupervised/unauthorized use of the gym is not permitted.
Spectators and pets must remain outside the fenced area. No cigarettes, food, gum, sunflower seeds or beverages on the field.

I read and understand the Facility Policy. *

Confirm

THIS AGREEMENT AFFECTS YOUR LEGAL RIGHTS. PLEASE READ IT CAREFULLY!

We request your understanding and cooperation in maintaining both your safety and health by reading and signing the following Informed Consent & Photo Release Agreement. Every person must read and understand this waiver before participating in Laxlife Camp activities. We recommend that you consult your physician prior to starting an exercise or fitness program, and prior to using our Facilities.

THE WAIVER

You, the Client/Guardian, are aware that there are risks associated with participating in lacrosse activities and exercise. Your participation is completely voluntary, and you freely accept and fully assume all responsibility for all risks, and all possibilities of personal injury, death, property damage or loss to yourself or any other person as a result of your participation in camp activities. You and your heirs, next of kin, executors, administrators and assigns agree:

a) to waive all claims, known or unknown, that you have or may have in the future against Laxlife, including their owners, officers, directors, agents, employees, volunteers, business operators, independent contractors and site property owners or lessees (List)

b) that Laxlife are not liable or responsible for any damage to, loss or theft of your property;

c) to release and forever discharge Laxlife from all liability for any personal injury, death, property damage or loss resulting from your participation in lacrosse or any other exercise activities, due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake in error of judgment by Laxlife; and

d) to be liable for and to hold harmless and indemnify Laxlife from all actions, proceedings, claims, damages, costs demands, including court costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with your participation in lacrosse or exercise activities.

PHOTO/VIDEO RELEASE

You, the Client/Guardian, hereby grant Laxlife, their Photographer, Film Crew, and their legal representatives and assigns (including but not limited to any agency, client or publication), irrevocable permission to publish photographs/videos of my child taken at the Laxlife Lacrosse Camp. These images may be published in any manner, including (but not limited to) program brochures, advertisements, periodicals, and the LaxLife website. Furthermore, I will hold harmless the aforementioned photographer and film crew and their legal representatives and assigns, from any liability by virtue of minor cropping that may be required, and colour and exposure shifts that may occur in reproducing photographs/videos.

I HAVE READ AND DO VOLUNTARILY SIGN THE RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISKS, RELEASE AND INDEMNITY AGREEMENT, and further state and agree that no oral representations, statements or inducement apart from the foregoing written agreement have been made. Furthermore, I permit my dependant to participate in the sport and activities of the Laxlife Lacrosse Camp under the terms of the foregoing Agreement.

Cancellation/Refund Policy

If something comes up and you have to cancel your registration, for any reason, please do so in writing and within 48 hours of your camp start date. We would be happy to give you a 100% credit of all fees paid. Not showing up for any reason other than the above specified, will not entitle you to a refund unless arranged prior to registration. Otherwise, your 100% credit will be honoured for up 2 years. Cash refunds will not be issued.

Primary Guardian *

Type full name to agree with terms.

I have read and agree to the terms and conditions *

Confirm

Are you interested in volunteering? *

Yes

Subtotal $176.99
Tax $23.01
Total $200