Parent Agreement

Registration to Play PTBYLA Lacrosse

The following is a republication of the agreement that you, as a parent, have agreed to when registering your

child to play lacrosse (via the use of an electronic signature).  This is reprinted here for reference only.

By registering your child, you agree to the following. You must scroll down to the bottom and select the "I / We Accept the

above" check box in order to complete registration. By completing this player registration, you affirm that you are the

parent and / or legal guardian for the player being registered. You agree that electronic acceptance shall be binding just as

an original signature.)

CONSENT TO PARTICIPATE / ACKNOWLEDGEMENT OF RISK / WAIVER & RELEASE OF LIABILITY / CONSENT TO MEDICAL

TREATMENT / CONSENT TO BE PHOTOGRAPHED

CONSENT TO PARTICIPATE: 

I / We give permission for my child to participate in Peters Township Boys Youth Lacrosse sponsored by the Peters

Township Boys Youth Lacrosse Association (PTBYLA). Participation will be in accordance with the PTBYLA By-Laws and in

full accordance with all insurance requirements and conditions set forth by PTBYLA. I shall not permit my child to

participate, represent or play in any PTBYLA contest, scrimmage, tournament, practice or other competition until my child

has been examined by a licensed physician of medicine or osteopathy before commencement of the Lacrosse season and

my child has been declared physically able to participate in the sport of Lacrosse by said physician.  I / We also

acknowledge that PTBYLA has strongly recommended that my child have completed concussion testing within the prior 6

months and that I / we ensure that an updated concussion baseline is on file with my child's physician of medicine. 

ACKNOWLEDGEMENT OF RISK:

I / We acknowledge that injuries including death might occur by participating in Boys Lacrosse since injuries including

death are inherent to any physical activity or sport. I / We understand that PTBYLA in conjunction with U.S. Lacrosse, Inc.

(US Lacrosse) is requiring General Liability-Excess Liability and Accident Medical Insurance for all participants in Boys

Lacrosse while participating on the field. This coverage is automatically provided by US Lacrosse by maintaining a valid up

to-date US Lacrosse membership for your child. In addition to this US Lacrosse provided coverage, I / we shall purchase

and maintain required continuous and uninterrupted medical insurance for my child during the period of participation in

lacrosse activities and shall retain complete responsibility for medical care and related expenses that may not be covered

by the above referenced US Lacrosse insurance. PTBYLA, and its agents, are authorized to contact and communicate with

our Medical Insurance provider for the sole purpose of verifying medical coverage provided for my participant child. I / We

agree that failure to provide continuous and uninterrupted medical insurance, and proof of said coverage upon reasonable

request, will result in my child being removed from participation in all PTBYLA activities and events. I / We shall promptly

notify PTBYLA in writing (at ptboyslax.help@gmail.com) of any changes to my / our child's medical coverage or information

that may occur during the season. 

I / We acknowledge that injuries including death might occur in the course of private or public transportation of my / our

child involving Boys Lacrosse warm-ups, practices, scrimmages, games, tournaments and any other activities as related to

Boys Lacrosse. I / We also recognize that that injuries can be dramatically reduced, minimized or eliminated when lacrosse

participants are properly protected by wearing approved and recommended equipment. I / We agree that our child shall

not participate in lacrosse warm-ups, practice, scrimmage, games, tournaments and any other lacrosse activities unless

wearing a properly fitted National Operating Committee on Standards for Athletic Equipment (NOCSAE) approved

protective helmet in addition to the following unaltered protective equipment: shoulder pads, rib pads, gloves, arm pads,

mouthpiece and a protective athletic cup. 

WAIVER AND RELEASE OF LIABILITY

I / We, for myself / ourselves and on behalf of my / our heirs, assigns, personal representatives and next of kin, hereby

release, agree to indemnify and hold harmless the Peters Township School District, the Peters Township Parks and

Recreation Board, the Peters Township Boys Youth Lacrosse Association, Coaches and instructors, members, sponsoring

agencies, sponsors, advertisers, and if applicable, owners or lessors of premises used to conduct an event and any agency

acting on behalf of PTBYLA from any expense that may be incurred in connection with injury to, including death of, my

child resulting from the participation in the sport of lacrosse or resulting from the transportation, either private or public as

related to a PTBYLA event or activity. 

CONSENT TO MEDICAL TREATMENT:

In the event of injury, accident, or sickness, I / we authorize PTBYLA to seek treatment for my / our child by a licensed

physician and/or hospital. Medical care and / or treatment may be given under whatever condition is necessary to preserve

life, limb or well being of my / our child.

CONSENT TO BE PHOTOGRAPHED & USE OF PHOTOGRAPHS:

I / we give permission to PTBYLA and/or parties designated by PTBYLA to photograph my child and use / publish such

photographs on the PTBYLA website and in all forms of media for any and all promotional purposes related to youth

lacrosse; including advertising, display, audiovisual, exhibition or editorial use. I / we understand that there will be no

financial compensation to me for my or my child's time or expenses for this consent to photograph and I / we release

PTBYLA from any and all claims. 

ACCEPTANCE:

Intending to be legally bound, I / we do hereby release, absolve and discharge Peters Township School District, the Peters

Township Parks and Recreation Board, the PTBYLA, its Executive Board members, coaches, employees, members and any

agent acting on behalf of PTBYLA from any liability to, or claims for damages related to, my child resulting from any cause

whatsoever, either unintentional or otherwise, in connection with participation in Peters Township Boys Youth Lacrosse

activities or events. I / We have read this Consent to Participate / Acknowledgement of Risk / Waiver & Release of Liability

/ Consent to Medical Treatment agreement(s) and have had an opportunity to consult legal counsel on the terms, fully

understand its terms, understand that I/ we have given up substantial rights by accepting it, and freely and voluntarily

without inducement agree to its terms by clicking on the "I / We Accept the above" check box below. I / We agree that

electronic acceptance shall be binding just as an original signature.