Lacrosse Spring 2020 Signup
Email address *
Parent/Guardian Name *
Your answer
Parent/Guardian DOB
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DD
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YYYY
Parent/Guardian Phone *
Your answer
Parent/Guardian Address *
Your answer
Emergency Contact Name & Phone *
Your answer
Child's First & Last Name *
Your answer
LAX League *
Child's Shirt Size *
Child's Current School *
Child's Current Grade for 2019-2020 School Year *
Child's Current Age *
Your answer
Child's DOB *
MM
/
DD
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YYYY
Child's High School Graduation Year *
Your answer
Child's Allergies/Medications (If none type none) *
Your answer
Child's Birthright *
Child's Residency *
Child's Meskwaki Status *
US Lacrosse partners with Bollinger Insurance to provide exclusive on-the-field coverage for all US Lacrosse members. However some medical issue(s) might not be covered under your US Lacrosse membership. Does your child have Medical Insurance?
$30 Payment- I understand that my payment goes towards US Lacrosse Membership, Iowa Lacrosse Membership, Lacrosse Sticks, (Boys Lacrosse Pads, Lacrosse Helmets), (Girls Goggles & New Uniforms) Fields, Officials, and Transportation. I also understand that since the MYP is sponsoring the Lacrosse program and paying for the majority of the fees we are not allowing Scholarship funding for the season.
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