$0.00

Player Information


Parent 1 Information

Parent 2 Information (optional)


Academic & Athletic Information


Emergency Contact Information


Waivers and Releases

Acknowledgment and acceptance is required to participate. Please read before accepting. Do not accept if you do not understand this:

In consideration of my participation in BrickLAX sponsored events and activities, I agree to the following:

Waiver and Release:
I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages and losses, associated with participation in a lacrosse event and related sports conditioning activities. I further agree on behalf of myself, my heirs and personal representatives, that BrickLAX along with coaches, officials, referees, volunteers, employees, agents, sponsors, officers, and directors of these organizations, shall not be liable for any injury, loss of life or other loss or damage occurring as a result of my/ my player's participation in the event.

BrickLAX Training:
I certify that by my child's participation in the BrickLAX camp series and its related activities, it is voluntary and I /my child will comply with the rules and player conduct policies of this event. Any violation of these rules or policies could result in the player forfeiting their right to play. With regard to this year and future years of participation, I acknowledge and fully understand that each participant will be engaging in activities that involve risk and serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. I agree to release, waive, discharge and covenant not to sue or hold liable and to hold harmless the BrickLAX LLC, its principals, administrators and other employees, organizers, sponsors, participants, and any person transporting me to and from BrickLAX activities, for any claim arising from injury to myself.

BrickLAX is a Limited Liability Corporation and assumes no responsibility. The Ownership, Administrators, Staff, Selection, are not responsible for any injuries to players or others, regardless of how sustained nor assume any responsibility for medical treatment of any player, nor payment of medical bills.

Medical Attention:
I hereby give my consent to BrickLAX LLC to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted in the course of my participation in BrickLAX sponsored or sanctioned events.

Readiness to Compete:
I will only participate in those competitions or activities in which I believe I am physically and psychologically prepared to participate.
As legal guardian of this participant, I hereby verify by my acceptance of this document that I have read and fully understand each of the conditions under Participant Waiver and Release section for permitting my child to participate in BrickLAX LLC sponsored events and activities and I accept each of the conditions, especially the waiver and release set forth in paragraph one. I also certify that the player is voluntarily participating in this event and they are aware of the risk of injury in playing Lacrosse. I also agree that the player is in good physical health to play lacrosse without causing harm to themselves or others.
I/We being the legal guardians of the applicant authorize BrickLAX and its agent's permission to request medical treatment as necessary to insure the well-being of our dependent.
A full refund, less processing fees, will be issued only for cancellations occurring 3 weeks prior to the start of camp. No refunds will be issued within 3 weeks of the start date.

Partial refunds will NOT be issued for late arrivals, early departures, injuries limiting play at the camp, or inclement weather.

Billing Information

  • Visa
  • Mastercard
  • American Express
  • Discover
Reg Fox by Webconnex
Secure Online Registration Powered by RegFox