Peters Township Boys Youth Lacrosse Association COVID-19 Waiver of Liability and Indemnification

As part of state, local, and federal guidelines, the Peters Township Boys Youth Lacrosse Association will be conducting a phased return to play. This protected return to play recognizes the risks associated with a return to play without a Food and Drug Administration recognized approved vaccine that prevents or mitigates the risk of contraction of COVID-19. This waiver, my signature and initials are evidence of my recognition that, by participating in the Peters Township Boys Youth Lacrosse Association return to play, my family and player(s) may be at higher risk of contracting COVID-19. My family agrees to comply with all Peters Township Boys Youth Lacrosse Association policies, rules, and guidelines including but not limited to all policies, rules, and guidelines regarding navigating play during COVID-19.  With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heirs, and executors, hereby forever release, waive, discharge, and covenant not to sue the Peters Township Boys Youth Lacrosse Association, its board members, officers, agents, and/or servants from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by my family and or player(s) related to COVID-19, whether caused by the negligence of the Released Parties, while participating in any Peters Township Boys Youth Lacrosse Association activity, practice, and or game.

Please initial and date by each section recognizing that you have read, understand, and agree to each section.

______I agree to immediately notify the Peters Township Boys Youth Lacrosse Board Association , through ptboyslaxinfo@gmail.com, if anyone in my immediate family tests positive for COVID-19.

______I agree to refrain from practice for 14 calendar days if anyone on my team notifies the Peters Township Boys Youth Lacrosse Association that they have tested positive for the COVID-19 virus.

______I agree that my player(s) will stay home if they feel ill in order to protect others.

______I agree to follow the Peters Township Boys Youth Lacrosse Association interpretations of all local and state guidelines which may include, but are not limited, to social distancing, face coverings, equipment modifications, and play modifications.

______I agree to follow these guidelines and understand these measures are designed to protect myself and others.

______I understand the incubation period of COVID-19 can be 2-14 days before feeling ill.

______I understand that once ill I can be contagious 2 days prior and for the duration of the illness.

______I understand that feeling ill is defined by the following symptoms:

  • Common

  • Fever > 100.4

  • Cough

  • Shortness of Breath

  • Less Common

  • Sore Throat/Congestion

  • Headache/Chills

  • Muscle and Joint Pain

  • Nausea or Vomiting

  • Loss sense of smell/taste

  • Diarrhea

  • Unusual tiredness

______I understand that the Peters Township Boys Youth Lacrosse Association will notify local health officials and the Peters Township Parks and Recreation Director if a player tests positive for COVID-19. The Peters Township Boys Youth Lacrosse Association will not share details beyond those required by state and federal guidelines. Internally, this information will be shared with Board Members and the coaching staff. Team members will be informed if a team member has tested positive, but the identity of the player will not be revealed by the coaching staff or board.

By signing below I acknowledge and represent that I have read the entirety of the foregoing Waiver of Liability, understand it and sign it voluntarily as my own free act and deed, including without limitation the Release of Liability and Indemnification requirements contained in this document:

  • I am sufficiently informed about the risks involved in playing lacrosse with the Peters Township Boys Youth Lacrosse Association to decide whether to sign this document; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made.

  • I am at least eighteen (18) years of age and fully competent; and I execute this document for full, adequate, and complete consideration fully intending to be bound by the same.

  • I agree that this Wavier of Liability shall be governed by and construed in accordance with Pennsylvania law, and that if any of the provisions hereof are found to be unenforceable, the remainder shall be enforced as fully as possible and the unenforceable provision(s) shall be deemed modified to the limited extent required to permit enforcement of the Wavier of Liability as a whole.

Parent name: ___________________________  Signature: ___________________________

Parent name: ___________________________  Signature: ___________________________

Player Name: ___________________________  Signature: ___________________________