GREAT WESTERN LACROSSE TOURNAMENT
2008 Player Information & Release Form

Player____________________________Age_____   Date of Birth_________

Address_________________________________________________________

City_________________________________ State______ Zip Code________

Email_____________________________ Telephone___________

Team______________________________________

Medical Coverage________________________   Policy Number__________

 I understand that: 1) My child is in good physical condition and has had a physical examination within one year  prior to the tournament;  2) I am hereby waiving and releasing the Great Western Lacrosse Tournament, its Director and its Staff from any and all liability for injuries incurred by my child while attending and participating in the Tournament even if arising from negligence; 3) I will pay all costs incurred by the Tournament as a result of any failure by my child to respect and maintain facilities and/or observe Tournament rules and regulations; 4) The Tournament and its Director are not responsible for my child while attending the
Tournament and that team chaperones and coaches are the responsible parties; 5) If my child is found to have possession of drugs, alcohol or weapons on the University premises, my child will be sent home immediately and without any refund of fees;
In the event that I am unable to give parental consent, I hereby authorize the Physician/Hospital Staff at the nearest
Hospital to provide care to include diagnostic procedures and medical treatment as necessary to my child, who is a minor. 
 (leave nothing blank)

Emergency Contact Phone________________________________________