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Camp Application
Disclaimer and Signature

WAIVER & INDEMNITY

I, THE UNDERSIGNED INDIVIDUAL, AGREE TO OBTAIN AT MY EXPENSE AND FOR MY OWN BENEFIT, DISABILITY, MEDICAL, HOSPITALIZATION AND LIABILITY
INSURANCE COVERAGE COVERING MYSELF IN SUCH AMOUNTS AS I SHALL DETERMINE, BUT IN ANY EVENT WHICH SHALL BE SUFFICIENT TO COVER AND PROTECT
ME FROM ANY AND ALL INJURIES, DAMAGES, CLAIMS AND LOSSES WHICH I MIGHT INCUR, OR FOR WHICH I MAY BE RESPONSIBLE IN, PARTICIPATING, AT THE
NEW ENGLAND COLLEGE OFFICIATING CAMP RUN IN CONJUNCTION WITH THE ISL/NEPSAC COLLEGIATE COACHES SHOWCASE AND IN TRAVEL TO AND FROM SUCH TOURNAMENT(S) AND SHALL SUBMIT PROOF OF SUCH INSURANCE TO CAMP DIRECTOR, LARRY LAST. I FURTHER HEREBY AGREE TO HOLD HARMLESS AND INDEMNIFY LARRY LAST, NEW ENGLAND COLLEGE OFFICIATING LLC AND ISL/NEPSAC COACHES SHOWCASE  COORDINATORS AND STAFF FROM ALL LIABILITY FOR ANY INJURY DAMAGE OR LOSS SUSTAINED AS A RESULT OF MY ACTIONS (OR INACTIONS) IN, PARTICIPATION AT SUCH CAMP AND IN THE PERFORMANCE OF OFFICIATING SERVICES, INCLUDING WITHOUT, LIMITATION, ALL CLAIMS FOR MEDICAL EXPENSES WHICH I MAY INCUR, OR OTHERWISE, DUETO MY FAILURE TO, OBTAIN AND/OR MAINTAIN SUCH APPROPRIATE INSURANCE COVERAGE.

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