Drew University Men's Lacrosse Prospect Clinic
Location: Drew University
Drew University
Men’s Lacrosse Prospect
Date:
July 23, 2015
Time:
10 am thru 4 pm
Cost:
$125.00
Payment payable to Drew University
Clinic
***Limited Registration*** For Information contact: Tom Leanos Drew Men’s Lacrosse Coach
For Rising High School Sophomores, Juniors and Seniors
973-408-3573 or [email protected]
July 23, 2015
Prospective student athletes will participate in a one day lacrosse prospect clinic supervised by the Drew University Men’s Lacrosse Coaches. Participants should wear appropriate athletic clothing and are responsible for bringing their own lacrosse equipment including all mandatory protective gear and mouth piece.
Clinic Schedule: Check in: 9:30 to 10:00 am Practice: 10:15 to 11:45 am Lunch: Noon to 1 pm Campus Tour: 1 pm to 2 pm Game: 2 pm to 4 pm
Registration form: Name__________________________________________________ Cell Phone_______________________________________________ Address_________________________________________________City______________________________State________Zip_________ Email___________________________________________________Graduation year: Circle one: 2016 2017 2018 High School______________________________________________Club team:_______________________________________________ Position:________________________________________________ Pre-‐registration is required: Complete and return the registration/payment and waiver/release below to: Tom Leanos, Simon Forum, Drew University, 36 Madison Ave., Madison, NJ 07940. WAIVER/RELEASE OF LIABILITY Participant’s ame________________________________________________________________________Age______________________ Home Address_________________________________________________City__________________St______________Zip___________ Cell Phone_________________________________Emergency Phone # (where you can be reached during clinic)____________________ As parent/guardian of the child named above, I understand the risks involved with my son participating in the lacrosse Prospect clinic sponsored by Drew University. I verify that my son has had a physical recently and may participate in all the activities of the lacrosse prospect day. I verify that he has no physical impairment/disabilities that make him prone to injury. I understand and acknowledge that in the case of illness, accident or injury, my child will be evaluated by and receive medical treatment from emergency response personnel. I further agree that Drew University, its agents, students, and employees, and the Drew Men’s lacrosse team shall be held harmless for injury, death or damage to property that occurs while my child is participating in the lacrosse clinic, except that which can be shown as negligence on the part of the College or its representatives. I acknowledge and understand that I am responsible for any and all bills for first aid, medical and emergency services for my child that result from any injury sustained while participating in the Drew Lacrosse prospect clinic. Parent/Guardian Signature:_______________________________________________________Date_____________________________ Please Print Above Name:_________________________________________________________________________________________
Drew University
Men’s Lacrosse Prospect
Date:
July 23, 2015
Time:
10 am thru 4 pm
Cost:
$125.00
Payment payable to Drew University
Clinic
***Limited Registration*** For Information contact: Tom Leanos Drew Men’s Lacrosse Coach
For Rising High School Sophomores, Juniors and Seniors
973-408-3573 or [email protected]
July 23, 2015
Prospective student athletes will participate in a one day lacrosse prospect clinic supervised by the Drew University Men’s Lacrosse Coaches. Participants should wear appropriate athletic clothing and are responsible for bringing their own lacrosse equipment including all mandatory protective gear and mouth piece.
Clinic Schedule: Check in: 9:30 to 10:00 am Practice: 10:15 to 11:45 am Lunch: Noon to 1 pm Campus Tour: 1 pm to 2 pm Game: 2 pm to 4 pm
Registration form: Name__________________________________________________ Cell Phone_______________________________________________ Address_________________________________________________City______________________________State________Zip_________ Email___________________________________________________Graduation year: Circle one: 2016 2017 2018 High School______________________________________________Club team:_______________________________________________ Position:________________________________________________ Pre-‐registration is required: Complete and return the registration/payment and waiver/release below to: Tom Leanos, Simon Forum, Drew University, 36 Madison Ave., Madison, NJ 07940. WAIVER/RELEASE OF LIABILITY Participant’s ame________________________________________________________________________Age______________________ Home Address_________________________________________________City__________________St______________Zip___________ Cell Phone_________________________________Emergency Phone # (where you can be reached during clinic)____________________ As parent/guardian of the child named above, I understand the risks involved with my son participating in the lacrosse Prospect clinic sponsored by Drew University. I verify that my son has had a physical recently and may participate in all the activities of the lacrosse prospect day. I verify that he has no physical impairment/disabilities that make him prone to injury. I understand and acknowledge that in the case of illness, accident or injury, my child will be evaluated by and receive medical treatment from emergency response personnel. I further agree that Drew University, its agents, students, and employees, and the Drew Men’s lacrosse team shall be held harmless for injury, death or damage to property that occurs while my child is participating in the lacrosse clinic, except that which can be shown as negligence on the part of the College or its representatives. I acknowledge and understand that I am responsible for any and all bills for first aid, medical and emergency services for my child that result from any injury sustained while participating in the Drew Lacrosse prospect clinic. Parent/Guardian Signature:_______________________________________________________Date_____________________________ Please Print Above Name:_________________________________________________________________________________________
