Last name _____________________________ First name ________________________

Address ______________________________________ City ___________ FL _______

Day phone _____________ Evening phone ___________

E-mail address ________________

Age _______ Team name _________________________________

In consideration of the acceptance of my entry in the Battle in the Box Southwest Florida Indoor Lacrosse Tournament, November 6 and 7, 1999, held at the TECO Arena in Fort Myers, Florida, I hereby release from their own negligence Fort Myers Indoor Lacrosse and Lee County Lacrosse, its directors, officers, and league organizers, sponsors, their respective employees and agents, and any other entities and individuals who are in any way connected with Fort Myers Indoor Lacrosse and Battle in the Box Southwest Florida Indoor Lacrosse Tournament play. I understand that lacrosse is a dangerous sport in which serious injury is always a possibility and hereby assume all risk associated with play. Further, I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, motion pictures, recordings, and any other record of this event for any legitimate purpose, including but not limited to marketing and promotion of the event, products, and/or sponsors associated with the event or Fort Myers Indoor Lacrosse. I understand that if I am under the age of 18 that I must have the permission of my parent or legal guardian to participate in Fort Myers Indoor Lacrosse League play. I, the undersigned parent or legal guardian, hereby consent to the applicant's participation and waive and release all rights and claims for damages as is more fully set forth above. I HAVE READ THE ABOVE RELEASE AND UNDERSTAND THAT I AM ENTERING TOURNAMENT PLAY AT MY OWN RISK.

______________________________ ______________________________________

Name Signature Date

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Signature of parent or guardian for players under 18 Date