Tournament Waiver and Release

Achieve Lacrosse subscribes to US Lacrosse for general liability and accident insurance through RPS Bollinger (on the condition that the event operator, all players and head coaches are active US Lacrosse Members.) Through Bollinger Insurance, US Lacrosse provides exclusive on-the-field coverage for all US Lacrosse members participating in Achieve Lacrosse tournaments.

All players attending the Achieve Lacrosse Tournaments must complete the below online waiver and tournament release. All participants must be active US Lacrosse members in order to receive supplemental insurance coverage if needed. In order to complete the online form below, all participants MUST provide a current US Lacrosse Membership Number and expiration date.

Are you a US Lacrosse Member, but need to find your membership number? CLICK HERE to look up your US Lacrosse number and expiration date.
If you are NOT a US Lacrosse member and need to obtain coverage or need to renew your membership, please CLICK HERE.

Xtremelax Player Waiver 2021

Participant Information
Achievelax Tournament*
Player Name*
First Last
Team
Emergency Contact Name
First Last
Emergency Contact Phone Number
Player Birth date:
Player Zip Code*
Health Concerns
US Lacrosse Number*
US Lacrosse Expiration Date*
Consent to Play and Liability Release
Consent to Play:*
I acknowledge that lacrosse is a high-speed sport which may involve some contact. I am aware of no medical conditions, illnesses or injuries that would prevent my child from participating in all aspects of this team membership, except as follows (Please state the medical condition and provide a letter from the child’s health care provider indicating the limitations or restrictions for the child’s participation):
Liability Release*
I hereby give permission to provide emergency medical assistance to my child in case of accident or injury. I agree to indemnify and hold harmless Achieve Lacrosse, Mass Elite Lacrosse, any individual working as an officer, coach, employee, agent or volunteer or in any capacity for this organization, for any and all injuries, damages, causes of actions or claims for personal injuries or property damage, arising from my child's participation in this program, or any leagues, teams or tournaments associated with Achieve Lacrosse and or Mass Elite Lacrosse.
Parent/Guardian First Name Parent/Guardian Last Name Date
Parent/Guardian Email Address*

Please enter a valid email address for confirmation of waiver submission.

Xtremelax Player Waiver 2021

Participant Information

Consent to Play and Liability Release