2011 COLLEGE VARSITY LACROSSE DAY REGISTRATION
First
Last
Email
T-Shirt Size: S – M – L – XL
- Select Size -
Small
Medium
Large
X-Large
Cell Phone
Home Phone
Address
City
State
Zip
Year in School
-- Select Class--
Senior
Junior
Sophomore
Freshman
School
Years Played
Position
-- Select Position --
Attack
Midfield
Defense
Goalie
US Lacrosse Number – (Not Mandatory But Encouraged)
US Lacrosse EX Date -(Not Mandatory But Encouraged)
Additional Info:
Parent’s/Guardian Name
Cell Phone
Emergency Contact other than the Parent above
Name
Relation:
Cell Phone
I acknowledge that I have read and accept the
NorCal Waiver of Liability.
Payment for Varsity Lacrosse Day will come up upon submission.
© 2005 Nor-Cal Lacrosse :: Site developed by
Phoenix Designs
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