Thank you for your interest in North Coast STORM lacrosse for the 2021 Fall season. Please complete the following form, review all details including waivers, and complete your registration with a one-time $25 payment.
RELEASE OF LIABILITY
READ CAREFULLY - THIS AFFECTS YOUR LEGAL RIGHTS
In exchange for participation in the activity of lacrosse organized by The HUKi Foundation, and/or use of the property, facilities and services of The HUKi Foundation, I agree for myself and (if applicable) for the members of my family, to the following:
- AGREEMENT TO FOLLOW DIRECTIONS/CODE OF CONDUCT. I understand that THE HUKi Foundation is founded on the core values of character, integrity, respect, encouragement, dependability, attitude and leadership. It is the expectation that all participants (coaches, players, parents) uphold these core values to build confidence in all who participate in The HUKi Foundation programs. I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by The HUKi Foundation, or the employees, representatives or agents The HUKi Foundation. The HUKi Foundation holds all participating North Coast Coaches, Players and Fans to a very high standard of Behavior. All participants (Coaches, Players, Fans) are expected to behave in a professional and positive manner while respecting the referees, opposing team coaches, league administrators and the game of lacrosse. Any insubordination on behalf of any party will not be tolerated and will be dealt with quickly and decisively. Any Referee or League Administrator has the 100% authority to eject and ultimately terminate any participants participation in the league. There are no appeals to these decisions as all decisions are final.
I understand that by participating in the North Coast Storm League run through the HUKi Foundation, I am also agreeing to having my child be photographed and or video taped by league approved photographers/videographers for use in promotional materials, social networking, brochures, pamphlets, websites, etc to help promote the league. I also agree that no monetary payment will be made for use of any and all of these photographs/videos taken.
- ASSUMPTION OF THE RISKS AND RELEASE. I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge The HUKi Foundation for injury, loss or damage arising out of my or my family's use of or presence upon the facilities used by The HUKi Foundation, whether caused by the fault of myself, my family, The HUKi Foundation or other third parties.
- INDEMNIFICATION. I agree to indemnify and defend The HUKi Foundation against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of The HUKi Foundation.
- FEES. I agree to pay for all damages to the facilities used by The HUKi Foundation caused by any negligent, reckless, or willful actions by me or my family.
- CONSENT. I, the legal guardian of the registered participant, consent to the participation of registered participant in the activity of lacrosse, and agree on behalf of the registered minor to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over and custody of the registered participant.
- MEDICAL AUTHORIZATION. In the event of an injury to the registered minor during any HUKi Foundation activities, I give my permission to the HUKi Foundation or to the employees, representatives or agents of the HUKi Foundation to arrange for all necessary medical treatment for which I shall be financially responsible. This temporary authority will begin on the first day of the season/camp/clinic and will remain in effect until terminated in writing or when the season/camp/clinic registered for is completed. The HUKi Foundation shall have the following powers:
- The power to seek appropriate medical treatment or attention on behalf of my child as may be required by the circumstances, including without limitation, that of a licensed medical physician and/or hospital;
- The power to authorize medical treatment or medical procedures in an emergency situation; and
- The power to make appropriate decisions regarding bodily nourishment and shelter.
- ENFORCEABILITY. The invalidity or unenforceability of any provision of this Agreement, whether standing alone or as applied to a particular occurrence or circumstance, shall not affect the validity or enforceability of any other provision of this Agreement or of any other applications of such provision, as the case may be, and such invalid or unenforceable provision shall be deemed not to be a part of this Agreement.
- DISPUTE RESOLUTION. The parties will attempt to resolve any dispute arising out of or relating to this Agreement through friendly negotiations amongst the parties. If the matter is not resolved by negotiation, the parties will resolve the dispute using the below Alternative Dispute Resolution (ADR) procedure. Any controversies or disputes arising out of or relating to this Agreement will be submitted to mediation in accordance with any statutory rules of mediation. If mediation does not successfully resolve the dispute, then the parties may proceed to seek an alternative form of resolution in accordance with any other rights and remedies afforded to them by law.
- For California Residents Only
I hereby expressly waiver all rights under Section 1542 of the Civil Code of the State of California, and under any and all similar laws of any jurisdiction. I am aware that said Section 1542 of the Civil Code provides as follows:
A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM MUST HAVE MATERIALLY AFFECTED HIS SETTLEMENT WITH THE DEBTOR.
I am the parent or legal guardian of the Participant. I am of legal age and am freely signing this Agreement. I have read this form and understand that by signing this form, I am giving up legal rights and remedies. I represent that I am parent/ legal guardian of the child named above, and I agree that the terms of this release are binding on me and the child. I also agree to allow the league to use my email address to communicate back activities related to the league and our partners. These emails are NOT to be used by anyone else involved in the league without prior consent from The HUKi Foundation. Any violations of the above rules and regulations will subject you to expulsion from the league.
HEADS UP Concussion Waiver
This sheet has information to help protect your children or teens from concussion or other serious brain injury. Use this information at your children’s or teens’ games and practices to learn how to spot a concussion and what to do if a concussion occurs.
WHAT IS A CONCUSSION?
A concussion is a type of traumatic brain injury—or TBI—caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move quickly back and forth. This fast movement can cause the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging the brain cells.
HOW CAN I HELP KEEP MY CHILDREN OR TEENS SAFE?
Sports are a great way for children and teens to stay healthy and can help them do well in school. To help lower your children’s or teens’ chances of getting a concussion or other serious brain injury, you should:
· Help create a culture of safety for the team.
o Work with their coach to teach ways to lower the chances of getting a concussion.
o Talk with your children or teens about concussion and ask if they have concerns about reporting a concussion. Talk with them about their concerns; emphasize the importance of reporting concussions and taking time to recover from one.
o Ensure that they follow their coach’s rules for safety and the rules of the sport.
o Tell your children or teens that you expect them to practice good sportsmanship at all times.
· When appropriate for the sport or activity, teach your children or teens that they must wear a helmet to lower the chances of the most serious types of brain or head injury. However, there is no “concussion-proof” helmet. So, even with a helmet, it is important for children and teens to avoid hits to the head.
HOW CAN I SPOT A POSSIBLE CONCUSSION?
Children and teens who show or report one or more of the signs and symptoms listed below—or simply say they just “don’t feel right” after a bump, blow, or jolt to the head or body—may have a concussion or other serious brain injury.
Signs Observed by Parents or Coaches
· Appears dazed or stunned.
· Forgets an instruction, is confused about an assignment or position, or is unsure of the game, score, or opponent.
· Moves clumsily.
· Answers questions slowly.
· Loses consciousness (even briefly).
· Shows mood, behavior, or personality changes.
· Can’t recall events prior to or after a hit or fall.
Symptoms Reported by Children and Teens
· Headache or “pressure” in head.
· Nausea or vomiting.
· Balance problems or dizziness, or double or blurry vision.
· Bothered by light or noise.
· Feeling sluggish, hazy, foggy, or groggy.
· Confusion, or concentration or memory problems.
· Just not “feeling right,” or “feeling down.”
Talk with your children and teens about concussion. Tell them to report their concussion symptoms to you and their coach right away. Some children and teens think concussions aren’t serious or worry that if they report a concussion they will lose their position on the team or look weak. Be sure to remind them that it’s better to miss one game than the whole season.
Concussions a ect each child and teen differently. While most children and teens with a concussion feel better within a couple of weeks, some will have symptoms for months or longer. Talk with your children’s or teens’ health care provider if their concussion symptoms do not go away or if they get worse after they return to their regular activities.
WHAT ARE SOME MORE SERIOUS DANGER SIGNS TO LOOK OUT FOR?
In rare cases, a dangerous collection of blood (hematoma) may form on the brain after a bump, blow, or jolt to the head or body and can squeeze the brain against the skull. Call 9-1-1 or take your child or teen to the emergency department right away if, after a bump, blow, or jolt to the head or body, he or she has one or more of these danger signs:
· One pupil larger than the other.
· Drowsiness or inability to wake up.
· A headache that gets worse and does not go away.
· Slurred speech, weakness, numbness, or decreased coordination.
· Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
· Unusual behavior, increased confusion, restlessness, or agitation.
· Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.
Children and teens who continue to play while having concussion symptoms or who return to play too soon—while the brain is still healing— have a greater chance of getting another concussion. A repeat concussion that occurs while the brain is still healing from the rst injury can be very serious and can a ect a child or teen for a lifetime. It can even be fatal.
What Should I Do If My Child or Teen Has a Possible Concussion? As a parent, if you think your child or teen may have a concussion, you should:
1. Remove your child or teen from play.
2. Keep your child or teen out of play the day of the injury. Your child or teen should be seen by a health care provider and only return to play with permission from a health care provider who is experienced in evaluating for concussion.
3. Ask your child’s or teen’s health care provider for written instructions on helping your child or teen return to school. You can give the instructions to your child’s or teen’s school nurse and teacher(s) and return-to-play instructions to the coach and/or athletic trainer.
Do not try to judge the severity of the injury yourself. Only a health care provider should assess a child or teen for a possible concussion. Concussion signs and symptoms often show up soon after the injury. But you may not know how serious the concussion is at rst, and some symptoms may not show up for hours or days. The brain needs time to heal after a concussion. A child’s or teen’s return to school and sports should be a gradual process that is carefully managed and monitored by a health care provider.
To learn more, go to www.cdc.gov/HEADSUP
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
The novel coronavirus, COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19 has been shown to spread easily from person-to-person and is considered extremely serious to the elderly and those with certain pre-existing medical conditions. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and other safeguards to prevent the spread of the virus among the populace.
I understand that North Coast STORM/CYL has established numerous preventative measures to reduce the spread of COVID-19; however, North Coast STORM/CYL cannot guarantee that anyone participating in a North Coast STORM/CYL program or using a North Coast STORM/CYL facility will not become infected with COVID-19. Further, attending North Coast STORM/CYL programs, activities and/or events could increase my risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected with COVID-19 by participating in a North Coast STORM/CYL program, activity and/or event or using a practice/game facility and that such exposure or infection may result in personal injury, serious illness, permanent disability, including death. I understand that the risk of becoming exposed or infected by COVID-19 at any North Coast STORM/CYL program, activity and/or event or utilizing a practice/game facility may result from the actions, omissions, or negligence of myself and others, including but not limited to North Coast STORM/CYL employees, officers, agents, volunteers, elected and appointed officials, other participants and their families.
I voluntarily agree to assume all of the forgoing risks and accept sole responsibility for any injury to myself (including but not limited to, personal injury, disability and death), and to include any and all damages, loss, claims, liability, or expenses of any kind, that I may experience or incur in connection with use of North Coast STORM/CYL rented facility or involvement in any North Coast STORM/CYL program.
I hereby release, covenant not to sue, discharge and hold harmless North Coast STORM Lacrosse/CYL, its employees, officers, agents, volunteers, elected and appointed officials; collectively “Released Parties,” of and from any and all claims, including all liabilities, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of North Coast STORM Lacrosse/CYL, including its officers, agents, employees, volunteers and elected and appointed officials and representatives, whether a COVID-19 infection occurs before, during or after participation in any North Coast STORM/CYL class or use of any city facility.
I acknowledge and represent that I have carefully read and understand all terms of this Release and Waiver of Liability.
Thanks for subscribing! Please check your email for further instructions.