2021 Burning Flower Waiver Form
Each participant in the Cy-fair Burning Flower Lacrosse Tournament must complete a waiver prior to beginning the tournament.
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Email *
Player's First Name *
Player's Last name *
Street Address *
City *
State *
Postal Code *
Current Grade Level *
Home Team Name *
What team do you identify with to be your team. Other teams that you may guest play on are considered Guest Teams.
Guest Team Name
Team that you will guest play on. If none, please skip to the next question.
Team Age Bracket *
US Lacrosse Member Number *
Have your received the COVID Guidelines *
Parent Email Address *
Please enter in Email, even if it is the same as above. Thank you.
Parent Contact Name *
Parent Phone Number *
Please enter your phone number in the following format 000-000-0000
Amateur Athletic Waiver and Release of Liability
Amateur Athletic Waiver and Release of Liability: In consideration for being allowed to participate in any way in the Cyfair Burning Flower Lacrosse Tournament, related events and activities, the undersigned acknowledges, appreciates and agrees: The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment and personal discipline may reduce the risk, the risk of serious injuries does exist; and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISK, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and I willingly agree to comply with the stated customary terms and conditions for participation. If however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Cyfair Iron Maidens Lacrosse Club, their officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lesser of the premises used to conduct the event (“RELEASEES”) WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE.
Parental Consent *
Guardian permission of the named player is given to participate in the tournament
A copy of your responses will be emailed to the address you provided.
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