Lacrosse Clinic Registration

Instructions
Thank You for your Registration. We will match it up to your Pay Pal Payment and see you soon

Your preferred position: *

Check off your preferred positionsGoalieDefenseMidfieldAttack

Players Name: *

Address *

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Players Date of Birth *

Pick a Program *

Girls Lacrosse ClinicBoys Lacrosse Clinic

Parent/Guardian Name: *

Primary Contact Cell # *

Primary Contact Email: *

Secondary Contact Name:

Secondary Contact Cell #

Secondary Contact Email:

I certify As the undersigned Parent/Legal Guardian of the Player named above I understand that my child will not be covered by any program insurance, and agree that I will not hold the team, the club, the coach, any instructors or Harford Sports Performance Center responsible for injuries received while participating in the above tryout and/or program.
Digital Signature *
YesNo
Date Signed: *
What level has your daughter played: *