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PRESEASON CAMP @ Dublin Jerome
Indicates required field
Date of Birth
In the consideration of Field Hockey Life LLC acceptance of my son or daughter as a student in sports for the period of dates mentioned above, and in return for the opportunity to participate in this camp:
I understand that a risk of participating in any sport , including Field Hockey Life LLC, is the risk of injury, including but not limiited to serious permenant injury, paralysis, and death. To minimize the risk of injury, I agree to tell my child to obey all safety rules and to report fully any problems related to her physical condition to the coaches as soon as the problem begins.
By accepting this waiver, I certify the following:
That my child is not currently under the care of a physican for an injury or illness
that would prevent her safe participation in the summer camp.
That my child is not currently being treated for or recovering from an orthopedic
injury that would prevent her safe participation in the summer camp.
That my child has no history of fainting or other problems related to strenuous
That my child is in good health and there is no reason that she cannnot safely
participate in strenuous physcial activity.
In accepting my child into Field Hockey Life LLC, I do hereby agree that I am and shall be responsible for all costs associated with any injury or loss that may be sustained by my child as a result of her participation at the club. I also certify that I have health insurance which provides adequate coverage for injuries or illness my child may sustain while participating in Field Hockey Life LLC.
By accepting this waiver, I also agree to release and promise not to sue Field Hockey Life LLC or their employees for any damages, loss, injury, or death arising from my child’s participation in Field Hockey Life LLC, unless such damages, loss, injury, or death are caused by willful and wanted conduct of such employees.
Do you understand, acknowledge and agree to all contents of the above FHL waiver? *
Yes, I understand and agree to the contents of the above waiver.
The Ohio Department of Health has announced new legislation referred to as
which addresses Sudden Cardiac Arrest in youth athletes. The law went into effect on August 1, 2017. The following resources were developed to implement Lindsay’s Law:
Required SCA Informational Handout
Required Signature Form
** Please note that ALL participates MUST print and sign the above signature form and turn it in at registration the first day of training.
I acknowledge that I have watched the video and receive the handout. *
Yes, I have watched the video and received the informational handout.
2017 Field Hockey Life, L.L.C. All Rights Reserved.
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