Did a club player refer you? If so, whom?
Player HS Graduation Year*
How Many Years of Lacrosse Experience
Player email ONLY. If player does not have an email address LEAVE BLANK. DO NOT ENTER PARENT INFORMATION.
Player phone number ONLY. If player does not have a phone number LEAVE BLANK. DO NOT ENTER PARENT INFORMATION!
Player US Lacrosse Number*
Parent #1 Cell Phone Number*
Parent #2 Cell Phone Number
Please let us know if your child has asthma, an allergy, or any other medical condition that we should be aware of to successfully support them.
Please let us know if your child self-carries an inhaler or Epi-Pen or any other medical items.
Flare Lacrosse will follow all federal and local guidelines as well as those provided by US Lacrosse, as part of our return to play protocols. This may include additional safety equipment, policies, or procedures, not limited to social distancing and limited spectator participation. These policies and plans are fluid and are subject to change at any time with CDC or state guidelines.
PLEASE READ CAREFULLY. No refunds will be made will be made for any reason UNLESS Flare Lacrosse discontinues a program or event. In the event of our discontinuation prior to a program's start, 100% of registration money will be returned. In the event a program has begun, we will refund the appropriate percentage for the remaining amount of time. There are absolutely NO other exceptions; this includes, but is not limited to: other team obligations, player illness/injury, personal conflict or cancellations due to inclement weather.
Use of Images/Name Identification*
I authorize Flare Lacrosse to use images of me and/or my player, both with and without name identification, for publicity, promotional and advertising purposes and release any and all claims and/or rights I and/or my player might have as a result.
Liability / Indemnity for Personal Injury*
I, for myself and/or my player, hereby release, discharge, and agree not to hold Flare Lacrosse, (its coaches, employees, volunteers, agents, and owners), liable for any claims, demands, losses, or damages on account of personal injury to me and/or my child caused or alleged to be caused in part or in any way related to facilities, equipment, and/or my or my player's participation in any training, program, game or other event organized, run and/or sponsored by Flare Lacrosse. On behalf of myself and my player, I agree to indemnify and hold harmless Flare Lacrosse from any and all claims, damages, demands, costs, expenses and compensation arising out of or in the course of or in any way related to any personal injury to me or my player. I understand the nature of the above referenced activities and the player’s experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, agree to indemnify and save harmless Flare Lacrosse from all liability, claims, demands, losses or damages on the minor’s account caused or alleged to have been caused in whole or in part by Flare Lacrosse and further agree that if, despite this release, I, the player, or anyone on the minor’s behalf makes a claim against Flare Lacrosse I will indemnify and save and hold them harmless from any litigation expenses, attorney fees, loss liability, damage, or costs they may incur as the result of any such claim.
Acknowledgement of Activity Risks*
I acknowledge that the activities offered by Flare Lacrosse include active sports which can result in injury to players and/or spectators. In the event I choose to leave my player, I hereby give Flare Lacrosse my permission to use its discretion in determining whether my player requires medical attention and, if so, to use its discretion in transporting my player, selecting a health care facility and obtaining treatment.
I acknowledge that in my absence Flare Lacrosse does NOT assume any responsibility for the care, custody, control, condition, health or well being of my player.
Were you referred to Flare by a coach or player? If so, let us know who they are so we can thank them!
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