Harrisburg Lacrosse Summer League 2019

 

TEAM REGISTRATION FORM

 

Return WITH TEAM FEE to:

 

Harrisburg Lacrosse

PO Box 13089

Harrisburg, PA 17110

 

MAKE CHECKS PAYABLE TO:                Harrisburg Lacrosse

 

RETURNING TEAMS LEAGUE FEE $1,300.00

NEW TEAMS LEAGUE FEE $1,400.00

Team Captain Name: ________________________________________         

Date of Birth: __________________

 

Street Address: ______________________________________________________________________

 

City/State/Zip: ______________________________________________________________________

 

Home Phone: ______________             Work Phone: _____________________

 

E-Mail Address: ________________________________________________

 

League you are signing up for:  Adult Summer ___  

 

Team Name:____________________________________

 

Player Names and E-mails:

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________  

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

Player Names and E-mails:

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________  

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

 

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________

________________________________   -   ________________________________