Summer Clinic

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Rutgers Lacrosse Clinic 2017 – Presented by Brand Elite LLC

Summer Clinic DATE: Wednesday July 26th 2017 TIME: 5:00-8pm REGISTRATION: 4:30-5:00pm Busch Campus E Fields (Grass) FEE: $120 T-Shirt Included! Please bring your own stick, goggles, mouth guard, goalie gear and water bottle. The clinic will include individual skill development, instruction on team concepts and small scrimmage play. Instruction will be provided by the Rutgers coaching staff and current Rutgers players.

Presented by Brand Elite LLC

WEDNESDAY JULY 26th Clinic Director: Laura Brand-Sias 14 seasons as Head Coach of Rutgers Lacrosse. Finished the 2016 season with a trip to the BIG10 Conference Championships and a win over Ohio State in the semi-finals

Directions: Rutgers E Fields Address: 83 Fitch Rd. Piscataway, NJ 08854 The grass fields are located between the Rutgers Bubble and Yurcak Stadium Parking located on Fitch Rd. or the grass lot in front of Yurcak

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Rutgers Girls Lacrosse Clinic To reserve a spot, please mail in the below waiver with your check. Each Player MUST fill out a registration form.

Please make checks payable to: Brand Elite L.L.C Registration Deadline– July 21st 2017 CANCELLATION POLICY The entire fee is non-refundable. Medical withdrawals will be considered prior to 7/21/17 with supporting documentations. Withdrawals after 7/21/17 will not be considered.

For any questions, please contact: Women’s Lacrosse at (732)-445-8853 or [email protected] -------------------------------------------------------------------------------------------------------------------------------------Name:___________________________________ Age: __________ Phone# (____ _) ____________________ Address:__________________________________ City:_____________________State:_______ Zip:_________ HS School: _______________________________ Club: ______________________________ HS Graduation Year:______________ Years Played:______________ Position: ________ Confirmation Email Address: ____________________________________________________________ Clinic Cost- $120: Amount Enclosed:_______________________ check payable to Brand Elite L.L.C Rutgers Girls Lacrosse Clinic Waiver and Assumption of Risk I hereby request that you accept the application of ______________________ in the 2017 Rutgers Girls Lacrosse Summer Clinic during the date set forth in this application, I hereby release Brand Elite L.L.C and Rutgers University, and all their trustees, officers, employees, and agents, from any and all liability of claims relating to any injuries that may be sustained by the camper while attending the 2017 Rutgers Girls Lacrosse Clinic or any and all claims which may hereafter be presented by or on behalf of the participant (minor child) relating to such injuries. Such released claims for negligence, gross negligence or recklessness. Authorization for Medical Treatment and Release: In case of emergency, if any medical attention is required by my child, I hereby give permission to Brand Elite L.L.C staff and/or Rutgers to secure medical treatment and to act on my behalf according to their best judgment, and I hereby release Brand Elite L.L.C and Rutgers University, and all their trustees, officers, employees, and agents, from any and all claims relating to the exercise of such judgment. I further acknowledge that the above named individual is covered by health insurance...

Date:_________ Parent/Guardian Name:___________________________Signature:________________________ Health Insurance Carrier:______________________________ Group/Policy#:______________________________ Emergency Contact:________________________ Telephone #:________________________________ *Mail completed forms and checks to: Rutgers Women’s Lacrosse, One Scarlet Knight Way, Piscataway, NJ 08854*