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Mahone Middle School Intramurals
Lacrosse Sign Up Form
Student's First and Last Name *
Your answer
Gender *
Student's Grade Level *
Student's House Name
T-Shirt Size *
Mother/Guardian's Name *
Your answer
Mother/Guardian's Phone Number
Your answer
Mother/Guardian's Email Address
Your answer
Father/Guardian's Name
Your answer
Father/Guardian's Phone Number
Your answer
Father/Guardian's Email Address
Your answer
Health Concerns
Please list any health concerns such as asthma, sore shoulder. etc.
Your answer
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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