EmailMe Form - Old Bridge Lacrosse Alumni Game

Name *

First Last

Email *

Cell Phone *

### - ### - ####

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Graduation Year (Odd or Even):

Position

Emergency Contact *

First Last

Emergency Contact Phone *

### - ### - ####

Assumption of the Risks, Release, Indemnifciation, and Hold Harmless Agreement: *

I have read the Hold Harmless Agreement and Agree

I acknowledge that I am eighteen (18) years of age or older, and agree to be legally bound as set forth in this document, for myself, my legal representatives, heirs, successors and assigns, and all who may claim through me or in my place.

I further do hereby agree that:

1. I am voluntarily participating in the alumni athletic game. I recognize that this event requires physical exertion that may be strenuous and may cause physical injury and I am fully aware of the risks and hazards involved. I hereby accept and expressly assume those risks. In consideration of being permitted to participate in the alumni athletic game, I voluntarily and knowingly agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the PROGRAM.

2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the alumni athletic game. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the alumni athletic game.

3. In further consideration of being permitted to participate in the alumni athletic game, I knowingly, voluntarily and expressly waive any claim I may have against Old Bridge Lacrosse and Old Bridge Board of Education, its employees, agents, an/or insurers for damages and injury, including death, which I may sustain as a result of participating in the alumni athletic game.

4. I, on my own behalf and on behalf of my heirs and legal representatives and all who may claim through me or in my place, forever release and agree to indemnify, hold harmless, discharge and covenant not to sue Old Bridge Lacrosse or Old Bridge Board of Education, its employees, agents, and/ or insurers, for any and all injury, liability, loss, damage, expense or cost of any kind, or nature, whatsoever from any and all claims for property damage, personal injury or death and/or any other claims arising from my participation in the alumni athletic game, including claims that are known or unknown, foreseen or unforeseen, future or contingent caused by my voluntary participation in the alumni athletic game.

5. I also authorize the event sponsors to utilize any photographs and/or video tape of my participation in the event for any and all purposes.

I have read the above assumption of risks, release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above and I intend to be legally bound by this Agreement. This agreement remains in effect for as long as I participate in the alumni athletic game.