JU Women's Lax Camp

Registration

Event Details

2010 Jacksonville University

Women's Lacrosse Camp

December 28-30th

Select your Event:

Player Info

First Name:*
Last Name:*
Address 1:*
Address 2:
City:*
State:*
Zip Code:*
Email Address:*
Mobile Phone:*

Player Details

Date of Birth:*
Positions:*	GK A M D
Sept 2010 Grade:*
Sept 2010 School Name:*
Club Name:
Club Years:
Yrs Exp MS:*
Yrs Exp JV:*
Yrs Exp VAR:*
Reversible Size:*

Special Instructions

Roommate Request:
Insurance Provider:*
Insurance Policy Number:*

Parent / Guardian 1 (Primary Contact)

First Name:*
Last Name:*
Email Address:*
Home Phone:*
Work Phone:
Mobile Phone:

Parent / Guardian 2

First Name:
Last Name:
Email Address:
Home Phone:
Work Phone:
Mobile Phone:

* I / We, understand this payment is non-refundable after November 1, 2010. Prior to this date, 50% of your camp fee is refundable. I / We understand that in order to seek a deposit refund, we must notify camp staff prior to November 1, 2010. All camp forms must be completed and post-marked no later than December 14th, 2010.

* I / We, being a parent or legal guardian of this camper, understand and accept the risk of injury is possible while playing the sport of lacrosse. I authorize the directors to act for me according to their best judgment in any emergency requiring medical attention. Anyone associated with MCC Sports, Inc will not assume campers' medical or dental expenses incurred as a result of participating in this camp. I agree to download all camp forms at JUlacrosse.com and return them to the camp prior to attendance.

Electronic Signature - Please Enter Parent/Guardian 1's First and Last Name

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