DREAM SPORTS LACROSSE, INC.
PARTICIPANT WAIVER

In consideration of my participation in Dream Sports Lacrosse, Inc. instructional programs and leagues, I agree to the following:

1.) Waiver and Release: I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis and even death, as well as other damages and losses, associated with participation in a lacrosse event and related sports conditioning activities. I further agree on behalf of myself, my heirs, and personal representatives, that Dream Sports Lacrosse, Inc., along with its coaches, officials, referees, umpires, volunteers, employees, agents, officers and directors, of these organizations, shall not be liable for any injury, loss of life, or other loss or damage occurring as a result of my participation in the event.

2.) Medical Attention: I hereby give my consent to Dream Sports Lacrosse, Inc. to provide , through a medical staff of its choice, customary medical/athletic training attention, transportation, and emergency medical services as warranted in the course of my participation in Dream Sports Lacrosse’s sponsored or sanctioned events.

3.) Readiness to Compete: I will only participate in those competitions or activities in which I believe I am physically and psychologically prepared to participate.

4.) Code of Conduct: I have read and agree to all the terms in the Code of Conduct on the second page of this form, especially with regard to my responsibilities as a Player.

Participant Primary Medical Insurance Carrier_______________________________________________________________

Policy Number________________________________

Signature of Participant:_______________________________________________________________ Date:____________

Print Name of Participant ________________________________________________

FOR ANY PARTICIPANT WHO IS NOT YET 18 YEARS OLD: As legal guardian of this participant, I hereby verify by my signature below that I have read and fully understand each of the above conditions for permitting my child to participate in Dream Sports Lacrosse, Inc. instructional programs and leagues, and I accept each of the above conditions, especially the waiver and release set forth in paragraph one.

Signature of Parent/Guardian _______________________________________________________________

Printed Name of Parent/Guardian _____________________________________________________