Seattle Starz Youth Girls Lacrosse Clinic
Please complete the form below to register for the Nov 25th Seattle Starz Youth Girls Lacrosse Clinic (5th-8th graders)
Participant First Name *
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Participant Last Name *
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Community Lacrosse Program *
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Participant's Grade *
Participant's Years of Experience
Parent Email 1 *
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Parent Email 2 *
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I acknowledge that I have registered either myself being 18 years of age or older) or my child (either myself or my child, as applicable, shall be referred to as the "Player") in one or more lacrosse programs organized by Rainier Lacrosse Club LLC., a Washington Limited Liability Company, DBA Seattle Starz (“Seattle Starz”). Seattle Starz is a licensee of Stars Lacrosse, Inc (Stars) a California corporation and/participates in one or more lacrosse programs organized by CHD, Inc., a California corporation ("Adrenaline"). Seattle Starz, Stars and Adrenaline collectively shall be referred to as "STARZ" and such programs collectively shall be referred to as the "STARZ Programs."

I agree to provide this release and waiver of liability of Seattle Starz, Stars and Adrenaline and each of their affiliates in exchange for the opportunity for the Player to participate in lacrosse. This waiver and release shall remain effective for so long as, and at any time that, the Player participates in any STARZ Programs.


I hereby represent that the Player is physically and mentally able to participate in lacrosse and has no health problems or physical or mental conditions that would present a risk to the Player or to others.


I represent that the Player is covered by comprehensive medical health insurance necessary to provide and pay for any and all costs of medical treatment (including transportation costs associated with obtaining medical care).


I understand, and the Player understands, that lacrosse:

1. Involves playing an aggressive contact sport with others.

2. The sport inherently involves a high degree of risk that could result in SERIOUS BODILY INJURY OR DEATH to the Player or to other participants.

3. Participants in the sport of lacrosse bear the risk of a number of bodily injuries arising in a contact sport with objects moving at high speeds, and the sport involves a high degree of risk of the following types of bodily injuries: Ligament sprain, Muscle strain, Contusion, Concussion, Fracture, Shoulder separation, Torn cartilage, Tendonitis/bursitis, Dislocation, Stress fracture, and Paralysis.
By enrolling the Player in the STARZ Programs, I certify that the Player is aware of all of the inherent dangers of participating in lacrosse. I further certify that the Player is familiar with the rules of the game and of the field and will to the best of his/her ability play under control and avoid injury to himself/herself and other persons playing the game. I understand that the Player should not participate in this program if he/she is under the influence of drugs or alcohol or if there are any other physical conditions that may impair his/her ability to understand instructions or to participate without creating risk to him/herself or others.


In exchange for the right for the Player to participate in the STARZ Programs, I hereby assume all risks associated with lacrosse, including the RISK OF SERIOUS BODILY INJURY, DEATH and/or PROPERTY DAMAGE and the negligence of Seattle Starz, Starz or Adrenaline, and I hereby agree NOT TO SUE Seattle Starz, Stars nor Adrenaline, nor their sponsors, directors, officers, employees, coaches, volunteers, instructors, agents, partners, sponsors, nor any of their affiliates ("STARZ Parties") and I release the STARZ Parties from any and all liability, claims or demands of every kind and nature whatsoever which may arise out of the Player participation in activities arranged by STARZ. I agree NOT TO SUE and I release the STARZ Parties and fully accept the risk of any illness or injury suffered by the Player while taking part in the STARZ Programs (including injuries that might cause death), including the ones listed above and other injuries common to contact sports. I release the STARZ Parties and fully accept the risk of any damage to property arising out of the STARZ Programs. This release will serve as a release and assumption of risk which binds my heirs, executors and administrators and for all members of my family.

I further state that I am of lawful age and legally competent to agree to this waiver and release, and that I understand the terms herein are contractual and binding. I have agreed to this release as my own free act and if I have any doubts concerning the contents of this waiver and release, I have had the opportunity to consult an attorney before agreeing to this waiver and release.

To the fullest extent permitted by law, I agree to indemnify, defend and hold harmless STARZ Parties from and against claims, damages, losses and expenses, including but not limited to attorneys’ fees, arising out of or resulting from the Player’s participation in the STARZ Programs. I agree to defend the STARZ Parties regardless of whether my duty to indemnity is disputed.


I hereby grant STARZ consent to provide, through a medical staff of its choice, customary medical/athletic training attention, transport the Player to an appropriate facility to receive emergency medical treatment and to authorize emergency medical treatment, including hospitalization. I grant permission to the medical personnel selected by STARZ to evaluate any injuries/illnesses, administer treatment, and make referrals for further care as deemed necessary. I understand and agree that the STARZ Parties assume no responsibility for any injury or damages which might arise out of such medical treatment. I agree to pay for any costs related to medical treatments that are not covered by insurance or if I have no medical insurance.

Waiver Agreement *
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