2021 ICE Medical Waiver Form

Participant Waiver (Players)

I, [FIRST NAME] [LAST NAME], hereby request you (Trilogy Lacrosse, LLC, TRILOGY) accept this agreement (Agreement) for my child’s participation in the TRILOGY Event listed on this form. In consideration of TRILOGY’S acceptance of this Agreement, I hereby agree to release, hold harmless, and indemnify Trilogy Lacrosse LLC, Haverford College, and all of their respective owners, agents, employees, sponsors, representatives, vendors, venue affiliates and assigns, from and for any and all claims resulting from any injuries, illness or death sustained by my child or any member of my family while participating in the Event, or in traveling to or from the Event. 

I acknowledge that my child’s participation in the TRILOGY Event listed on this form includes possible exposure to and illness from infectious diseases such as COVID-19 and I willingly assume full responsibility of these risks. I certify that my child has not recently tested positive for, is not exhibiting any symptoms of, or has been in contact with someone confirmed to have COVID-19 nor has any member of my household or any individual that may attend the event with my family. I agree that my child, and anyone accompanying me to the Event will comply with all policies and precautions required by TRILOGY to ensure the safety of my child and other participants. Furthermore, I understand that my child’s refusal to comply with these precautions may result in TRILOGY requesting their removal from the Event. 

I acknowledge that lacrosse is a contact sport, and understand that, although rare, there is a risk of serious injury or death associated in playing the sport. I hereby give permission to the coaches, training staff, and other medical professionals to provide medical care as deemed necessary to my child in case of any injury or illness. 

I acknowledge and agree that I am responsible for outfitting my child with the appropriate equipment (stick, gloves, elbow pads, shoulder pads, mouth guard and helmet) for the Event, and I agree that my child will wear their helmet at all times on-field during the Event.

I certify that I have read and explained all of the provisions in this waiver to my child including the risk of possible exposure to infectious diseases such as COVID-19. My child understands and accepts these risks and responsibilities to adhere to the policies and procedure required by TRILOGY to mitigate these risks.

Photos and video taken of my child while participating at the Event may be used in and for any TRILOGY publications and advertisements. I warrant and represent that I have the authority to sign this Agreement on behalf of my minor child. Signing this Agreement, and registration of my child in the Event, shall act as my consent for any such advertising usage. 

I acknowledge that I have read this Release, fully understand its content and have signed below of my own free will.

Who will be participating?

Adult  Players

Signee Information (Parent/Guardian)

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.