Team Jamaica Tryouts REGISTER BELOW TO TRYOUT FOR A SPOT ON TEAM JAMAICA TO PLAY IN THE 2018 FIL Lacrosse World Championships | July 12-21, 201 in Netanya, Israel TEAM JAMAICA LACROSSE TRYOUTS If you are human, leave this field blank. OPEN Registration - Cost $125 End Section CONTACT INFORMATION Name * First Name * Last E-mail * Address * Mobile Phone * End Section Upload a headshot of yourself * JAMAICA CONNECTION Where were you/your parents/grandparents born in Jamaica What is your relation to Jamaica? * I WAS BORN THERE ONE OR BOTH OF MY PARENTS WERE BORN THERE ONE OR BOTH OF MY GRANDPARENTS WERE BORN THERE I AM A NATURALIZED CITIZEN I HAVE NO RELATION TO JAMAICA Do you have a Jamaican passport? * YES NO NOT CURRENTLY BUT I CAN APPLY AND OPTAIN ONE End Section EDUCATION & EXPERIENCE High School College Did or Do you play lacrosse in college? * YES NO N/A IF YES. Did you play: * D1 D2 D3 Club Position * ATTACK DEFENSE LSM MIDDIE FOGO GOALIE Highlight reel URL #1 Highlight reel URL #2 Lacrosse accomplishments * End Section HEALTH Dominant Hand * RIGHT LEFT Date of Birth (m/d/yyyy) * Weight & Height * Have you ever had a concussion? * YES NO IF YES, how many? List any medical issues List current or past sports injuries End Section Why do you want to represent Jamaica at the 2018 FIL World Cup? * Are you AVAILABLE TO TRAVEL to Israel in July 2018 for the FIL World Cup? * YES NO Are you FINANCIALLY ABLE TO FUND your travel expenses to Israel in July 2018? * YES NO PARTIALLY Will you NEED ASSISTANCE to cover expenses to travel to Israel in July 2018? * YES NO MAYBE SOCIAL MEDIA Please list your username's Instagram Twitter Website/URL Blog/URL End Section Is there anything else you would like us to know? RELEASE Player Release AGREEMENT: In consideration of my participation in the sponsored activities of the JAMAICA LACROSSE ASSOCIATION camp/clinic/tournament, I acknowledge, agree to and understand that: Waiver Terms and Conditions: The undersigned person, parent or legal guardian hereby agrees to enroll the participating student based on the terms and conditions stated herein. The undersigned parent(s) or legal guardian(s) are hereinafter collectively referred to as “I” or “me.” I. Medical Insurance Information: I understand that every participaant is required to have health insurance coverage that provides an appropriate level of benefits befitting a participant in a contact sport. I affirm that my child/I has an appropriate level of coverage. II. Waiver, Assumption of Risk, and Release of Liability: I recognize that participation in The Program places the participating student/adult at physical risk, as there is an inherent risk of injury when participating in a contact sport. I agree to assume that risk. Although JAMAICA LACROSSE ASSOCIATION directors have taken reasonable measures to protect the participating student, I realize accidents, illness and injuries may still occur. I hereby waive, release and forever discharge JAMAICA LACROSSE ASSOCIATION, the Venue, and all coaches and staff, representatives, employees, contractors, successors and assigns of any of the preceding of and from any and all rights and claims for damages to person and property which may be sustained or occur during participation in The Program by the participating student whether paid damages, injury or loss are due to negligence or not. III. Media Waiver I understand that JAMAICA LACROSSE ASSOCIATION occasionally uses photographs and/or video of JAMAICA LACROSSE ASSOCIATION events such as The Program for promotional purposes. I grant JAMAICA LACROSSE ASSOCIATION permission to use the participating student’s name, image, voice, and identity in any program for promotion of JAMAICA LACROSSE ASSOCIATION including written materials, website materials, video, audio, or other forms damage occurring as a result of my participation in the event, or as a result of equipment that may have been provided to me for these activities. 2. MEDICAL ATTENTION: I hereby give my consent to US Lacrosse and the host organization of any JJAMAICA LACROSSE ASSOCIATION related event to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and/ or emergency medical services as warranted in the course of my participation in JAMAICA LACROSSE ASSOCIATION events. 3. READINESS TO COMPETE: I will only participate in those Jamaica Lacrosse competitions for which I believe I am physically and psychologically prepared to compete. 4. CODE OF CONDUCT: I have read and agree to all terms in theJAMAICA LACROSSE ASSOCIATION Code of Conduct, especially with regard to my responsibilities as a player. I agree to the Terms and Conditions * AGREE End Section NOTE: YOUR APPLICATION WILL NOT BE ACCEPTED UNTIL THE $125 REGISTRATION FEE IS SUBMITTED REGISTRATION FEE * I understand that in order to tryout, the registration fee must be paid. End Section Submit
REGISTER BELOW TO TRYOUT FOR A SPOT ON TEAM JAMAICA TO PLAY IN THE 2018 FIL Lacrosse World Championships | July 12-21, 201 in Netanya, Israel