Beltway Lacrosse (BLX)
MEMBERSHIP/PARTICIPANT FULL RELEASE AND
WAIVER FORM

BELTWAY LACROSSE (BLX) MEMBERSHIP/PARTICIPANT FULL RELEASE AND WAIVER FORM
IN CONSIDERATION OF BEING ALLOWED TO PARTICIPATE IN ANY LEAGUE, TOURNAMENT, CLINIC, PROGRAM, RELATED EVENTS, AND ACTIVITIES (“PROGRAM”) OF THE BELTWAY LACROSSE (BLX), THE UNDERSIGNED (“PARTICIPANT”) UNDERSTANDS, ACKNOWLEDGES, AND AGREES AS FOLLOWS:
1. The risk of serious injury arising from participation in the Program is significant, including the potential for permanent paralysis and death. Participant represents and warrants that Participant has no physical limitations that would prevent Participant from participating in the Program. Program rules, equipment and personal discipline may reduce the risk of injury; however, there may be risks and dangers not currently known or foreseeable arising from participation in the Program.
2. Participant KNOWINGLY AND FREELY ASSUMES ALL RISKS, both known and unknown, and whether or not such risks are foreseeable, in connection with participation in the Program. EVEN IF SUCH RISKS ARISE FROM THE NEGLIGENCE OF THE PARTICIPANT, RELEASEES (defined below) or others, Participant assumes the risk of injury or death and takes full responsibility for participation in the Program.
3. Participant willingly agrees to comply with the stated and customary terms and conditions for participation (“Rules”) and to bring to the attention of the nearest official any violation of such Rules by any third party.
4. Knowing and understanding the risk inherent in participation in the Program, Participant on behalf of Participant’s heirs, executors, beneficiaries, successors, assigns, personal representatives and next of kin, HEREBY RELEASES AND HOLDS HARMLESS BELTWAY LACROSSE (BLX) , its members, officers, directors, officials, agents, and/or employees, other participants, volunteers, its affiliates, sponsoring agencies, sponsors, advisors, as well as owners and lessors of the premises to conduct the Program (collectively “RELEASEES”) from any claims, causes of action, lawsuits, or actions, arising from or with respect to ANY AND ALL INJURY, DISABILITY, DEATH, loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
5. [California only] Participant hereby waives the protection of California Civil Code section 1542, which reads:
A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially affected his or her settlement with the debtor.
6. The person signing this document hereby represents that he or she has advised the RELEASEES of any facts known to him or her which would make the Participant more susceptible to injury or risk of injury as a result of participating in the Program than would be the average person of the same age. Any parent or legal guardian signing further represents that he or she has thoroughly explained to the minor
Participant the risks associated with participating in the Program using language appropriate to the age and intellectual capacity of the Participant.
7. To the full extent permitted under the law, Participant agrees to INDEMNIFY, DEFEND and HOLD HARMLESS RELEASEES against any and all claims, demands, causes of action, lawsuits, losses, expenses, damages, attorneys’ fees, costs, liability in law or equity, of every kind and nature whatsoever, arising out of or in connection with any act or omission of Participant during Participant’s participation in the Program, including but without limitation personal injury, disability, death or property damage to Participant or RELEASEES.
8. Any image or likeness of Participant can be used by Beltway Lacrossefor promotional purposes with full permission of Participant.

COVID-19
• The undersigned acknowledges that novel coronavirus (”COVID-19″) infections have been confirmed throughout the United States. In accordance with the most recent guidance and recommendations issued by the Centers for Disease Control and Prevention (CDC) for slowing the transmission of COVID-19, the undersigned hereby agrees, represents, and warrants that neither the undersigned nor such participating children shall visit or utilize the facilities, services, and/or programs of BELTWAY LACROSSE (BLX) (other than any exclusively online services and programs) within 14 days after:
(i) returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice
(ii) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or
(iii) exposure to any person who has a suspected or confirmed case of COVID-19.
• The CDC Travel Health Network is continuously updating this list and the undersigned agrees that they are aware of this list and the countries listed. The undersigned agrees to check on a daily basis the CDC Travel Health Notices list https://wwwnc.cdc.gov/travel/notices prior to participating in or utilizing the facilities, services, and programs of Beltway Lacrosse (BLX). The undersigned hereby agrees, represents, and warrants that neither the COVID-19 PLAYER LIABILITY WAIVER Beltway Lacrosse (BLX) undersigned nor such participating children shall participate in, visit or utilize the facilities, services, and/or programs of Beltway Lacrosse (BLX) if he or she:
(i) experiences symptoms of COVID-19, including, without limitation, fever, cough, loss of sense of taste or smell, or shortness of breath, or
(ii) has a suspected or diagnosed/confirmed case of COVID-19. The undersigned agrees to notify program director (1st) or coach (2nd, if 1st is not available) immediately if he or she believes that any of the foregoing access/use restrictions may apply.
Beltway Lacrosse (BLX) has taken certain steps to implement certain recommended guidance and recommendations issued by public health agencies for slowing the transmission of COVID-19, including, without limitation, the access/use restrictions set forth above. Beltway Lacrosse (BLX) Covid-19 Risk Mitigation Strategies can be accessed here www.beltwaylacrosse/waivers The undersigned acknowledges and agrees that Beltway Lacrosse (BLX) may revise its procedures at any time based on updated recommended guidance and recommendations issued by public health agencies and further agrees to comply with Beltway Lacrosse (BLX) ’s revised procedures prior to utilizing the facilities, services, and/or prior to participating in the programs of Beltway Lacrosse (BLX) . The undersigned further acknowledges and agrees that, due to the nature of the facilities, services, and programs offered by Beltway Lacrosse (BLX), social distancing of 6 feet per person among children and their fellow participants or others is not always possible. The undersigned fully understands and appreciates both the known and potential dangers of participating in the programs and/or utilizing the facilities and services of Beltway Lacrosse (BLX) and acknowledges that use thereof by the undersigned and/or such participating children may, despite Beltway Lacrosse (BLX) ’s reasonable efforts to mitigate such dangers, result in exposure to COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.
I HAVE CAREFULLY READ THIS ADDENDUM TO THE Beltway Lacrosse (BLX) LIABIITY WAIVER AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT AND FURTHER AGREE THAT NO ORAL REPRESENTATIONS, STATEMENTS OR INDUCEMENT APART FROM THE FOREGOING WRITTEN AGREEMENT HAVE BEEN MADE. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES FROM Beltway Lacrosse (BLX) IN CASE OF ILLNESS, INJURY, DEATH OR PROPERTY LOSS OR DAMAGE, INCLUDING, FOR THE AVOIDANCE OF DOUBT AND WITHOUT LIMITATION, EXPOSURE TO COVID-19 AT ANY Beltway Lacrosse (BLX) UTILZIED FACILITY OR DURING PARTICIPATION IN ANY PROGRAM AND ANY ILLNESS, INJURY OR DEATH RESULTING THEREFROM. I UNDERSTAND THAT THIS DOCUMENT IS A PROMISE NOT TO SUE AND A RELEASE OF AND INDEMNIFICATION FOR ALL CLAIMS. IF SIGNING ON BEHALF OF MINOR: I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BEHALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS AND I REPRESENT AND WARRANT TO Beltway Lacrosse (BLX) THAT I HAVE FULL AUTHORITY TO SIGN THIS AGREEMENT ON BEHALF OF SUCH MINOR(S).

Electronic Signature Agreement By selecting the “I Accept” button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By selecting “I Accept” you consent to be legally bound by this Agreement’s terms and conditions. You further agree that your use of a key pad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide Beltway Lacrosse (BLX) or in accessing or making any transaction regarding any agreement, acknowledgement, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as “E-Signature”), acceptance and agreement as if actually signed by you
in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and Beltway Lacrosse (BLX) .You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement.

Beltway Lacrosse

DMVI - Sixes Youth Fall league - Girls PreK to 7/8