Little Laxers Summer Camp | Medusa Lacrosse

Medusa Little Laxers
Summer Camp
GARDEN CITY

Players First Name:

Players Last Name:

Email Address (to be used for camp updates):

US Lacrosse Membership Number (for insurance purposes)

I, for myself or as the parent or legal guardian of the above named registrant recognize the possibility of serious physical injury or death associated with physical activities including lacrosse. I, from this day forward hereby forever release, discharge, hold harmless, Medusa LLC, it’s employees, representatives, agents, and associated personnel against any and all claims, causes of actions, and/or liability by or on behalf of the registrant as a result of the registrants’ participation in Medusa LLC events. in any and all of the practices, camps, special events, league events, tournaments, and showcases (hereinafter collectively "Events") including but not limited to traveling to and from such events locally and out of state. I hereby consent and agree that Medusa LLC has the right to take photographs and/or videos of the above named registrant for feedback, social media (facebook, instagram, Medusa Athletics website), advertising, and marketing. I AM SIGNING THIS DOCUMENT WITH AN ELECTRONIC SIGNATURE AND I AGREE THE SAME SHALL BE CONSIDERED AN ORIGINAL. ******PLEASE PRINT PARENT/GUARDIAN NAME BELOW********

Your Signature

**a small processing fee will be added onto payment at checkout**

Thank you for your registration! Go Medusa!

Medusa Athletics
Lacrosse & Field Hockey

Medusa Little Laxers
Summer Camp
GARDEN CITY

Medusa Lacrosse & Field Hockey

Medusa Athletics Lacrosse & Field Hockey

Medusa Little Laxers Summer Camp GARDEN CITY

Medusa Athletics
Lacrosse & Field Hockey

Medusa Little Laxers
Summer Camp
GARDEN CITY