[email protected] Lake Sammamish GIRLS ...
Registration Form
Name: __________________________________
Lake Sammamish GIRLS LACROSSE Summer Camp For all Eastside Eagles Players 2012-2013
Address: ________________________________ City, St.: ___________________Zip: __________ Phone: (_____) ___________________________ Parent E-Mail: ________________________________________________
Grade in Fall 2012: _______________________ Age: ________ Year of Experience: _________ Position: GK Defense
Midfield
Attack
2nd Grade to 8th Grade
School: _________________________________ Camp you are signing Up for:
Lacrosse Camp July31st to Aug.2nd $90.00 9:30am to 12:30pm Please make checks payable to: VanD’al Lacrosse Send full payment to: Tony D’Alessio Attn: Lacrosse Camp 45525 SE 141st St. North Bend WA. 98045
For all Eastside Eagles Players Featuring: Coach Tony D’Alessio Lake Sammamish Varsity
Parent Release: I verify that my child has been seen by a licensed physician and is physically able to participate in this camp. I hereby authorize the staff of this camp to act for me, according to its best judgment in any medical emergency: while attempts are made to contact me. I waive and release this camp from any and all liability, injuries, or illness incurred while attending this camp. The camper shall use the facilities at the Perrigo Park at her own risk. The coaches of Vand’al Lacrosse and its staff shall not be liable for any damages. ______________________________ ____________ Parent Signature
Date
And other coaches and varsity players Presented by Vand’al Lacrosse
For more information go to: www.eagleslacrosse.org e-mail: [email protected]
July 31st to Aug. 2nd Perrigo Park, Redmond 9:30am to 12:30pm. Presented by Vand’al Lacrosse
Name: __________________________________
Lake Sammamish GIRLS LACROSSE Summer Camp For all Eastside Eagles Players 2012-2013
Address: ________________________________ City, St.: ___________________Zip: __________ Phone: (_____) ___________________________ Parent E-Mail: ________________________________________________
Grade in Fall 2012: _______________________ Age: ________ Year of Experience: _________ Position: GK Defense
Midfield
Attack
2nd Grade to 8th Grade
School: _________________________________ Camp you are signing Up for:
Lacrosse Camp July31st to Aug.2nd $90.00 9:30am to 12:30pm Please make checks payable to: VanD’al Lacrosse Send full payment to: Tony D’Alessio Attn: Lacrosse Camp 45525 SE 141st St. North Bend WA. 98045
For all Eastside Eagles Players Featuring: Coach Tony D’Alessio Lake Sammamish Varsity
Parent Release: I verify that my child has been seen by a licensed physician and is physically able to participate in this camp. I hereby authorize the staff of this camp to act for me, according to its best judgment in any medical emergency: while attempts are made to contact me. I waive and release this camp from any and all liability, injuries, or illness incurred while attending this camp. The camper shall use the facilities at the Perrigo Park at her own risk. The coaches of Vand’al Lacrosse and its staff shall not be liable for any damages. ______________________________ ____________ Parent Signature
Date
And other coaches and varsity players Presented by Vand’al Lacrosse
For more information go to: www.eagleslacrosse.org e-mail: [email protected]
July 31st to Aug. 2nd Perrigo Park, Redmond 9:30am to 12:30pm. Presented by Vand’al Lacrosse
