2008 TOP 16 SUMMER SHOOTOUT
Lacrosse Tournament
WAIVER FORM


1.        Each of the undersigned hereby states: I am fully aware of and appreciate the risks,
including the risk of catastrophic injury, paralysis, and even death, as well as other damages and
losses, associated with participation in a lacrosse tournament or lacrosse event.  I agree on behalf
of myself, my heirs, and personal representatives that the Top 16 Summer Lacrosse Shootout
Tournament and their members, owners, directors, officers, agents, employees, and volunteers
(collectively the “Covered Parties”) shall not be held liable for any injury, damage to personal
property, loss of life or other loss or damage as a result of my participation in the Top 16 Summer
Shootout Tournament or any activities relating to the Top 16 Summer Shootout Tournament or
conducted by the Covered Parties.  It is my specific intention that none of the Covered Parties
shall have any liability whatsoever as a result, or in connection with my participation in the Top 16
Summer Shootout Tournament; I hereby waive any claims that I might have against any Covered
Parties and release all Covered Parties from any such liability; and I agree to indemnify the
Covered Parties against any such claims. In addition, I hereby give my consent to the Top 16
Summer Shootout Tournament, the owners and operators of the Top 16 Summer Shootout
Tournament Tournament and all other Covered Parties to provide, through medical staff of its
choice, customary medical/athletic training attention, transportation and emergency medical
services as warranted in the course of my participation in activities related to the Top 16 Summer
Shootout Tournament.
Not withstanding the foregoing, I understand and agree that none of the Covered Parties have any
obligation to provide any such medical/athletic training attention and the lack of any such
medical/athletic training attention or the provision thereof on a voluntary basis shall be covered by
the waiver and release set forth in this paragraph.

2.        In accordance with the NCAA bylaws, I hereby acknowledge that I have paid in full to be a
participant in the 2008 Top 16 Summer Shootout Tournament. I also acknowledge that I have not
received any discount to be a participant from any University or College or any persons
representing any University’s or College’s athletic interests.




Print Applicant’s Name: _______________________________________________

Applicant’s Signature ______________________________________Date________

Print Parent/Guardian Name ________________________________

Parent/Guardian Signature¬__________________________________Date________

Health Insurance Carrier ______________________________________

Policy #____________________________________________________
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UNIVERSITY LACROSSE TRAINING CENTER
@ Baltimore Lutheran School Fieldhouse
1145 Concordia Drive
Baltimore, MD 21286
UNIVERSITY LACROSSE TRAINING CENTERS
@ Annapolis Area Christian School Kilby
Athletic Center - 109 Burns Crossing Road
Severn, MD 21144