parents night out-4(1)
Parents’ Night Out with Drew Women’s Lacrosse: October 18 th Need an adult night out? Parents’ Night Out is a great way to give your children (AGES 4-12) and yourself a well-deserved night out! Drop off is 6pm.* Pick up is 8pm.* The cost is $40.00** for 1 child which will include sporting activities like lacrosse, basketball, soccer etc., pizza and drinks, as well as fun filled night with our excellent staff, the Drew Univeristy Women’s Lacrosse Team. *Early half-hour drop off and late half-our pick up is available for an extra $10.00 each. **Sibling Discount: 2 children are $60.00, and each additional child is $10.00. Future dates will be posted on our Facebook page and through parents’ emails. Send checks to: Julia Steier, Drew University Athletics, 36 Madison Ave. Madison, NJ 07940 Make Checks Payable to: Drew Women’s Lacrosse *Please call the Drew Women’s Lacrosse office at 973-408-3087 or email Julia Steier at [email protected] or Kaitlyn Dalziel [email protected] for any questions you may have* Name: _____________________________________
Cell Number: _________________________________
Address: ______________________________________________________________________________________________ Age: ____________ Email: _____________________________________________ Release and Medical Treatment Authorization In consideration of and through my involvement in the Drew University Women’s Lacrosse Clinics, I (or on behalf of my minor child) knowingly and freely assume all such risks; and release, hold harmless and promise not to sue the officials, agents, and/or the employees. I certify that (or on behalf of my minor child) in the event of injury or illness during my participation at the Drew University Clinic that all costs are my responsibility. In addition, I do hereby grant permission for duly authorized medical treatment by certified professionals to be administered to my child in the event of injury or illness during my participation at Drew University. Participants signature:
Date signed:
Parent/Guardian Name:
Parent/Guardian signature:
Insurance Company:
Policy # :
Cell Number: _________________________________
Address: ______________________________________________________________________________________________ Age: ____________ Email: _____________________________________________ Release and Medical Treatment Authorization In consideration of and through my involvement in the Drew University Women’s Lacrosse Clinics, I (or on behalf of my minor child) knowingly and freely assume all such risks; and release, hold harmless and promise not to sue the officials, agents, and/or the employees. I certify that (or on behalf of my minor child) in the event of injury or illness during my participation at the Drew University Clinic that all costs are my responsibility. In addition, I do hereby grant permission for duly authorized medical treatment by certified professionals to be administered to my child in the event of injury or illness during my participation at Drew University. Participants signature:
Date signed:
Parent/Guardian Name:
Parent/Guardian signature:
Insurance Company:
Policy # :
