DECLARATION OF GOOD PHYSICAL CONDITION & CONSENT TO EMERGENCY MEDICAL TREATMENT

 

I declare and acknowledge that (or on behalf of my minor child), to the best of my knowledge, I (or minor child) am in good physical condition and have no disease or injury that would impair my performance or result in my being injured during any LIFT Field Hockey program participation.

Also, I hereby consent (or on behalf of my minor child) to emergency medical treatment, hospitalization or other medical treatment as may be necessary for the welfare of myself (or minor child) by a Certified Athletic Trainer, Physician, or other appropriate healthcare professional, and/or hospital in the event of an injury or illness during the periods of time in which they are participating in a LIFT Field Hockey program.  I understand and agree that all related costs are my responsibility. 

I acknowledge and agree to: the risk of bodily injury, including without limitation scrapes, broken bones, paralysis, dismemberment, and death; and knowingly and freely assume all such risk. This includes injury of damage sustained while and/or resulting from use of any equipment or training provided by LIFT Field Hockey. 

I, and on behalf of my minor child, promise not to sue LIFT Field Hockey, the coaches, staff, or board members of said organization with respect to any and all such assumptions of risk.

I acknowledge that I have carefully read this ASSUMPTION OF RISK, WAIVER AND RELEASE OF LIABILITY agreement, fully understand its terms, understand that I have given up substantial rights by signing it, including the right to bring a legal action or assert a claim against LIFT Field Hockey or the coaches, staff, or board members of said organization, and sign it freely and voluntarily.