GREAT WESTERN LACROSSE CAMPS - 2026 PLAYER APPLICATION - Dates July 8 - 12
Please fill out all requires spaces on this form or we cannot process your application.
Please use an email that you readily check as all correspondence with the camp will be done through email.
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Email *
Choose your camp *
You must select the camp you want to attend. Please do not skip.
Player's First Name *
Player's Last Name *
Street Address *
City *
State *
Zip Code *
Parent Cell Number *
Players Cell Number *
Overnight / Day Camper Selection *
You must select overnight camper or day camper below
Required
Grade *
Please indicate the grade you finished in June 2025
Date of Birth *
(00/00/0000 format)
Age *
School / Team *
Please indicate what school team your son attends. Do NOT put down travel teams.
Desired Roommates *
Please indicate the names of the other players attended that you wish to room with. Maximum of 12.
Please write N/A if you are a day camper.
Position *
Please select the position you wish to play at camp. You MUST select one. Please do not skip.
Required
I need to rent equipment for camp
THIS QUESTION IS OPTIONAL - Please select the correct box indicating what equipment is needed.
Parents Names *
Please list the first and last names of both parents
Parent E-mail *
please ensure accuracy as all communication will be sent to this address
Player E-mail
If different than parents. If they do not have one, leave blank
Emergency Contact Name, other than parent *
Emergency Contact Phone *
(000-000-0000 format)
USA Lacrosse Membership Number *
This number is mandatory to attend camp: If you need help finding your number, go to https://memberlookup.usalacrosse.com/usl/index?_ga=2.26879359.33238571.1627952527-2070329869.1627952527. If you need to become a member, go to: https://membership.usalacrosse.com/login
USA Lax Membership Exp. Date *
CAMP RELEASE
I understand that:    
   1) My child is in good physical condition and has had a physical examination by a certified physician within six months prior to camp;  
   2) I am hereby waiving and releasing the Great Western Lacrosse Camp, its Director and its Staff from any and all liability for injuries incurred by my child while attending and participating in Camp even if arising from negligence;  
   3) I will pay all costs incurred by the Camp as a result of any failure by my child to respect and maintain University/Camp facilities and/or observe Camp rules and regulations causing property damage;  
   4) The Camp and its director/staff are not responsible for my child prior to check-in at the University and after Check-out from the University;  
   5) If my child is found in possession of any drugs, alcohol, cigarettes, fireworks or weapons on Camp/University premises or commits an act of violence or bullying while attending Camp, I am aware that my child will be sent home immediately without any refund of fees.
   6) I am aware that the Camp and its Director is not responsible for my child while being transported to and from the Airport, should I be using the transportation services of the Camp.
   7) I am aware that we have a zero tolerance for all bullying while at camp and I have discussed bullying with my child.

I am aware that I MUST remit all remaining fees by June 15th and that failure to do so will result in a late fee of $25.00 being charged.

By signing below, I am entering into a legal contract willfully and faithfully.

In the event that my child is injured and I am unable to give parental consent, I hereby authorize the Physician/Hospital Staff at any Hospital to provide care to include diagnostic procedures and medical treatment as necessary to my child, who is a minor.  

Yes, I have read the above Great Western CAMP release form and agree to the terms *
Required
Great Western Lacrosse Programs Waiver and Release of Liability
Amateur Athletic Waiver and Release of Liability Form
Read Carefully before signing

In consideration of being allowed to participate in any way in a Great Western Lacrosse athletic sports programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury from activities involved in this program is significant, including the potential for permanent injury and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and, assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Great Western Lacrosse Company, its Director, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event {“RELEASEES”}, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without inducement.

This is to certify that I, as parent / guardian with legal responsibility for this participant, do consent and agree to his release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, even if arising from negligence.

Yes, I have read the above waiver/release of liability and agree to the terms *
Required
COVID Waiver Form
By indicating your acceptance, you understand, agree, warrant and covenant as follows:
1. Agreement. In consideration of my child's participation, I hereby release and covenant not to sue San Diego County, California State University San Marcos, Russ Olsen, Great Western Lacrosse Camps and any instructors, coaches or agents, from any and all present and future claims resulting from ordinary negligence on the above named player/s for property damage or personal injury arising as a result of engaging in or receiving instruction in lacrosse associated with the youth clinic/camp.
2. Waiver. YOU UNDERSTAND THAT PARTICIPATION IN THE EVENT IS POTENTIALLY HAZARDOUS, AND THAT A REGISTERED PARTY SHOULD NOT PARTICIPATE UNLESS THEY ARE MEDICALLY ABLE AND PROPERLY TRAINED. YOU UNDERSTAND THAT EVENTS MAY BE HELD OVER PUBLIC ROADS AND FACILITES OPEN TO THE PUBLIC DURING THE EVENT AND UPON WHICH HAZARDS ARE TO BE EXPECTED. PARTICIPATION CARRIES WITH IT CERTAIN INHERENT RISKS THAT CANNOT BE ELIMINATED COMPLETELY RANGING FROM MINOR INJURIES TO CATASTROPHIC INJURIES INCLUDING DEATH. YOU UNDERSTAND AND AGREE THAT IN CONSIDERATION OF BEING PERMITTED TO PARTICIPATE IN THE EVENT, YOU AND ANY REGISTERED PARTY, THE HEIRS, PERSONAL REPRESENTATIVES OR ASSIGNS OF YOU OR THE REGISTERED PARTY DO HEREBY RELEASE, WAIVE, DISCHARGE AND CONVENANT NOT TO SUE FOR ANY AND ALL LIABILITY FROM ANY AND ALL CLAIMS ARISING FROM PARTICIPATION IN THE EVENT BY YOU OR ANY REGISTERED PARTY.
3. Severability. You further expressly agree that this Agreement and Waiver is intended to be as broad and inclusive as is permitted by the law of the State of California and that if any provision of this Agreement and Waiver shall be found to be unlawful, void, or for any reason unenforceable, then that provision shall be deemed severable from this Agreement and Waiver and shall not affect the validity and enforceability of any remaining provisions.
4. COVID-19: I acknowledge, understand, and appreciate that the novel coronavirus infection (“COVID-19”) has been confirmed throughout the United States, including several cases within California and surrounding states. I understanding that COVID-19 extremely contagious and, although the state of medical knowledge is evolving, it is general believed that the virus is spread from person-to-person contact, by contact with contaminated surfaces and objects, and/or in the air. I understand and agree that (i) despite reasonable efforts Great Western Lacrosse cannot prevent me from becoming exposed to, contracting, or spreading COVID-19 while participating in an Great Western Lacrosse Program; and (ii) that due to the nature of the facilities, services, and programs offered by Great Western Lacrosse, social distancing may not be possible. Therefore, I understand that if I participate in a Great Western Lacrosse Program I may be exposing myself to, or increasing my risk of contracting or spreading, COVID-19.
I further understand that if infected with COVID-19 I could become sick, seriously injured, quarantined, disabled, or even die. Moreover, in accordance with guidance and protocols issued by the Centers for Disease Control and Prevention (CDC) and the State of California, regarding slowing the transmission and spread of COVID-19, I agree, represent, and warrant, that I shall not participate in a Great Western Lacrosse Program or visit any facility where a Great Western Lacrosse event is being held if I:
(i) have experienced symptoms of COVID-19 (including without limitation, fever (100º or higher), cough, shortness of breath, excessive tiredness, diarrhea, nausea, loss of smell, or other flu and cold like symptoms) within the last 14 days; (ii) have been in close contact with anyone who has been a confirmed carrier of the COVID-19 virus; or (iii) have a suspected or diagnosed/confirmed case of COVID-19.
I hereby forever release and waive my right to bring any suit, action, or proceeding against California State University San Marcos, Great Western Lacrosse and its owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives in connection with the exposure, infection, and/or spread of COVID-19.
*
BY INDICATING YOUR ACCEPTANCE OF THIS AGREEEMENT AND WAIVER, YOU ARE AFFIRMING THAT YOU HAVE READ AND UNDERSTAND THIS AGREEMENT AND WAIVER AND FULLY UNDERSTAND ITS TERMS. YOU UNDERSTAND THAT YOU ARE GIVING UP SUBSTANTIAL RIGHTS, INCLUDING THE RIGHT TO SUE. YOU ACKNOWLEDGE THAT YOU ARE SIGNING THE AGREEMENT AND WAIVER FREELY AND VOLUNTARILY, AND INTEND BY YOUR ACCEPTANCE TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF ALL LIABILITY TO THE GREATEST EXTENT ALLOWED BY LAW.

Yes, I have read the Covid waiver above and agree to the terms *
Required
USA Lacrosse Participant Waiver and Release of Liability
for participation in a Great Western Lacrosse Camp Program
Instructions:
   1.) Each Player should read the statement below before completing and signing this Waiver & Release Form.
   2.) Parents / Guardians should read the statement below before completing and signing this Waiver & Release Form.

Agreement:
In consideration of my membership in US Lacrosse and of my participation in the sponsored activities of the Great Western Lacrosse Summer Camp Program, I acknowledge, agree to and understand that:

  1.) Readiness To Compete: Voluntary and of my own free will, I elect to participate as a member of a Great Western Lacrosse Summer camp Program. I will only participate in those US Lacrosse competitions and activities sponsored by Great Western Lacrosse for which I believe I am physically and psychologically prepared to compete.

  2.) Readiness To Compete: I hereby give my consent to US Lacrosse and to Great Western Lacrosse, California State University San Marcos and the host organization of any US Lacrosse sponsored event to provide through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted through the course of my participation in sponsored lacrosse activities.

  3.) Waiver & Release of Liability: I am fully aware of and appreciate the risks associated with participation in a lacrosse event, including the risk of catastrophic injury, paralysis and even death, as well as other types of damages and loss. I further agree on behalf of myself, my heirs, and personal representatives, that US Lacrosse, Great Western Lacrosse, California State University San Marcos, the host organization, and sponsors of any US Lacrosse event, along with their coaches, 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(s). My signature below is my acknowledgement that I have read and understood every provision of this Waiver and Release of Liability, and that I agree to abide by it.

Yes, I have read the USA Lacrosse waiver above and agree to the terms *
Required
Medical Information Form
Please answer the following question about your sons' health. This information will be used by our trainer to better serve your child.
Our family doctor is *
Please list the family doctor's phone number *
Our Medical insurance Company is *
You must have medical insurance coverage to attend all camps.
Our Medical insurance policy number is *
You must have medical insurance coverage to attend all camps.
My son is allergic to the following *
Required
If You listed other in the above question, please list what your son is allergic to...
This question is only required if you answered "OTHER" in the question above.
I attest that all the above medical information is correct and that I do, in fact, have current medical insurance coverage for my son. *
Required
Parent Signature *
For all Waivers above
Parent Signature Date *
For all Waivers above
Two Last Questions...
I learned about the camps from: *
Required
Who referred you to this camp? Use a specific name...
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