Portsmouth Abbey School Portsmouth, RI

Consent, Release, Waiver, and Covenant not to Sue

RE: ________________________________________________ (Participant’s Name)

________________________________________________ (Participant’s Street Address)

________________________________________________ (City, State Country, Zip or Postal Code)

________________________________________________ (Telephone Number)

I, ____________________________________________________________________ of (Name of Parent or Legal Guardian)

_______________________________________________________________________ (City and State of Residence of Parent or Legal Guardian)

as parent/legal guardian of the above-named “Participant,” who is under 18 years of age, do hereby give my consent for his/her participation in all activities which are a part of the New England Top 150 Lacrosse Camp Inc., held on the Portsmouth Abbey School campus, sponsored by the New England Top 150 Lacrosse Camp Inc., from July 8, 2018 through July 13,2018.

I hereby acknowledge my awareness that said New England Top 150 Lacrosse Camp Inc, may involve sports in which personal injuries can occur to participants, and as consideration for being allowed to participate in said New England Top 150 Lacrosse Camp Inc., I, on behalf of myself and the Participant, hereby release, waive, covenant not to sue, and do hereby indemnify and agree to hold harmless the President and Trustees of Portsmouth Abbey School, its officers, trustees, employees, agents and related parties (hereinafter “Portsmouth Abbey School”), from and for any and all liability for any loss, injury or damage, including, without limitation, any and all such liability arising from the negligence of Portsmouth Abbey School, but with the exception of those caused by reckless, willful, or wanton misconduct on the part of Portsmouth Abbey School, which may be sustained by me or the Participant as a result of, or directly or indirectly related to the Participant’s entry upon and use of Portsmouth Abbey Schools’ facilities for the purpose of participating in any aspect of said New England Top 150 Lacrosse Camp Inc.

I am 18 years of age or older. I have read and understood this Consent, Release, Waiver and Covenant Not to Sue.

Signature of Parent/Legal Guardian:_______________________________________________

Date:_____________________________________

Release Portsmouth Abbey