Waiver & Forms

I understand that by registering I have accepted and agreed to the waiver and release agreement(s) presented to me during the registration and that these documents include a release of liability and waiver of legal rights and deprive me of the right to sue certain parties.  By agreeing electronically, I have acknowledged that I have both read and understood any waiver and release agreement(s) presented to me as part of the the registration process and accept the inherent dangers and risks which may or may not be readily foreseeable, including without limitation personal injury, property damage or death that arise from participation in the event. 

Waiver of Liability: In consideration of participating in the Central Dauphin East Jr. Lacrosse Program, the player named above and the parent or guardian do hereby agree ourselves, our heirs, executors and administrators, to release, hold harmless and forever discharge Central Dauphin East Jr. Lacrosse program, all school districts, townships, public or private enterprises whose fields or facilities we may use, their officers, staff, administrators, volunteers, sponsors and representatives and assigns, for and against any and all claims, actions, cause of actions, suits, judgments and demands whatsoever directly or indirectly in connection with the player's participation in the Central Dauphin East Jr. Lacrosse program.  By agreeing below, I acknowledge that I have read and understand this form and further understand the terms herein are contractual and not a mere recital. 
Treatment/Medical Release Authorization: I/we being being the legal guardians of the applicant authorize the staff of the Central Dauphin East Jr. Lacrosse program and its agent's permission to request treatment to ensure the well being of our dependent.  I certify that he is in good health and able to participate in the scheduled games and practices.  I have included an explanation of any physical limitations and/or required medical attention that is necessary for my dependent.

Covid 19/Pandemic Waiver: Participation includes possible exposure to and illness from infectious diseases including but not limited to influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness does exist.

CD East Jr. Lacrosse will from time to time take photographs and video of games, practices, and other associate club events. Please utilize this form to indicate if you give our club permission to use your child’s image as part of the club’s social media, web, and print promotitional activity. If you select “decline,” your child’s image will not be used. This form must be completed by the child(ren)’s parent/guardian ever season. 

CD East Jr Lacrosse relies on family volunteers to help run a successful youth lacrosse program. If you are interested in volunteering, please indicate which areas you are willing to help out in:

Please indicate which district/high school your home address is currently zoned to. Pleaes contact the club at cdeastjrlacrosse@gmail.com if you have any questions.