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Mahone Middle School Intramurals
Lacrosse Sign Up Form
Student's First and Last Name
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Gender
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Student's Grade Level
Student's House Name
T-Shirt Size
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Mother/Guardian's Name
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Mother/Guardian's Phone Number
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Mother/Guardian's Email Address
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Father/Guardian's Name
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Father/Guardian's Phone Number
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Father/Guardian's Email Address
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Health Concerns
Please list any health concerns such as asthma, sore shoulder. etc.
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Payment
Intramural Lacrosse is a free activity for all students interested
Game Schedule
Intramural Lacrosse will meet on Wednesdays at 7:10 am to 8:10 am.
Lacrosse Skill Level
Mother/Father/Guardian's Permission
By submitting this form we/I the parent(s) or guardian(s) do hereby acknowledge that we/I fully understand the possibility of the risk of serious injury involved in athletic participation and do hereby grant our student permission to participate in intramural sports. We/I also agree to monitor our student athlete’s health and report any change of health conditions to the league advisor. We/I also grant the league advisor permission to take reasonable medical steps including the calling of an ambulance to convey him/her to a hospital in case of serious injury. Please check the following box for your approval.
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