Girls Lacrosse Registration
Girls Lacrosse Registration
Participant’s Name
Parent E-Mail Address
Street Address
Home Phone
Cell Phone
Mother’s Name
Mother’s Work Phone
Father’s Name
Father’s Work Phone
Emergency Contact Name
Emergency Contact Phone
Other Email Address
Participant’s Date of Birth
Participant’s Age
Participant’s Sex
Participant’s Grade and School
Participants Medical Conditions / Allergies
Describe Disability and Special Care if Applicable
Sibling Name if in the same league
Shirt Size (Choose one)  * 
Would a parent like to be a COACH? Please check one  * 
If you would like to coach, please provide name
How many season has your child played? Please choose one.  * 
No refunds or credits will be granted within 5 days prior to a program draft or session start date.
By submitting this registration I am acknowledging that I have read and understand the Participant Waiver and Release of Liability Form and its terms.
Would you like to make a donation to support our programs?  * 
Your Email Address  * 
Base Price $
Modifications $
Total $
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