NoVa West & SMS Lacrosse
Outbreak Program
 Select Team Information Collection & Payment

Congratulations on your selection to the best summer lacrosse opportunity around.  The Outbreak program will provide it's players with a great team, the highest level of competitive recruiting tournaments and sixty plus years of coaching experience.  The recruiting possibilities by being a committed part of this team are endless.
 
This is a time sensitive and confidential offer. You have 24 hours after receipt of this offer to accept a committed position on the team.  If you can not commit to this incredible opportunity simple respond to the email that this link was sent with.  Any offers not responded to after 24 hours will be cancelled and a replacement will be offered the opportunity.
 
By accepting this opportunity you agreeing to be a committed member of the Outbreak program which means you will attend all practices and tournaments. We will probably have four practices with our first two being July 1st & 2nd at Catholic University.
 
Selections to the Outbreak Team is a sensitive process, Please do not discuss your selection with other players until after July 1st. 

  

Player:
first last
Address:
street
city
state zip
email
Team Fee:
   Registration, Uniform & Coaches Fees
Tournaments:
 Crab City Challenge (1) 7/11- 12
 The Brine Shootout (1, 2) 7/12 - 15
  (1) These tournaments are mandatory to be considered for Outbreak
  (2) This tournament must be paid directly to the tournament website:
      Click Here The password when you register is HOYAS and select the NoVa West/SMS
       team!
Total: Payment to NoVa West, will be initiated once you acknowledge the waiver below
WAIVER AND RELEASE OF LIABILITY
    
1. Waiver and Release. The risk of injury from participating in lacrosse is significant and includes serious injury, including permanent disability, death, and other losses, both to me and my property. I understand that these injuries and losses might result not only from my actions, but the actions, inactions or negligence of other persons. I agree that I am responsible for my safety while participating in lacrosse. I ASSUME ALL RISKS CONNECTED WITH ANY INJURY OR LOSS RELATED TO OR ARISING OUT OF MY PARTICIPATION IN LACROSSE. I am aware of the risks of participating in lacrosse and I am willing to assume them. Accordingly, I release, waive, and hold harmless NoVa West Lacrosse. and each of these persons’ affiliates, subsidiaries, officers, directors, employees, agents, coaches, trainers, doctors, officials, volunteers, organizers, sponsors, and all other persons, from all claims by me for any liability, injury, loss or damage in any way related to or arising out of my participation in lacrosse camp. I intend for this waiver and release to also apply to any next of kin, relatives, personal representatives, heirs, beneficiaries, or assigns who might pursue any legal action on my behalf or in connection with any injury to me.
    
2. Medical Emergency. I understand that NoVa West Lacrosse, will make every effort to notify the camper’s parent or legal guardian of a medical emergency involving their camper. Notwithstanding this, as parent or legal guardian, I/we give permission to NoVa West Lacrosse, and its agents, to, at any time they believe an emergency exists, provide, facilitate, and consent to the provision of any first aid, doctor’s care, dental care, hospitalization, or medical care that camper may need because of an injury that the camper may suffer while participating in lacrosse camp. I/we agree to be financially responsible for any medical bills incurred as a result of medical treatment provided to the camper and understand that NoVa West Lacrosse, does not carry any medical insurance for campers. I understand it is my responsibility to maintain sufficient accident and medical insurance.
    
I HAVE READ THIS WAIVER AND RELEASE CAREFULLY. I UNDERSTAND IT AND I AM SIGNING IT VOLUNTARILY. I certify that as parent/guardian of the camper, I consent to his/her agreement to be bound by each of the terms and conditions in this waiver and release. I also certify that I am bound by each of the terms and conditions in this waiver and release.
    
 
Parent / Guardian Signature *
 

 
yes, I agree with the terms of this waiver

 
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NoVa West Lacrosse, PO Box 2058, Purcellville, Virginia 20132 • Phone. 540.338.3669