GREAT WESTERN SUN SMASH MEMORIAL LACROSSE TOURNAMENT
2012 Player Information & Release Form

Player__________________________________________ Age______   Date of Birth_____________

Team________________________________________________   Grade as of June 2012_________

Address___________________________________________________________________________

City_______________________________________________ State_______ Zip Code____________

Email_____________________________________________ Telephone_______________________

Medical Insurance__________________________________   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 Sun Smash Lacrosse Tournament, its Director and its Staff, and San Diego State University 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. 

Parental Signature___________________________________________________________

Date______________________