Dodgeball Fundraiser - Registration Form
First Annual Ashland
TOWNWIDE DODGEBALL FUNDRAISER!
Ashland High School Gymnasium

Saturday, March 9, 2019 starting at 2:00PM:
Divisions:
Grades 1 & 2
Grades 3 & 4
Grades 5 & 6
Grades 7 & 8
HIGH SCHOOLERS AND ADULTS CAN NOW SIGN UP!!!

Start times will be assigned closer to the event when we know the number of teams registered.
Start times will be assigned from youngest grades to oldest.

Cost per team: $50 (all proceeds go to Ashland Youth Lacrosse)

Objective: To eliminate all the players on the opposing team.
Failing this, to have the most players remaining when time is up

PLAYING PROCEDURES – No Head Hunting!
1. Play will be 5 on 5 – teams limited to five players.
2. Each team will play 2 sets of 3 games each (6 games total)
3. Each game will run for a maximum of 2 ½ minutes.
4. Teams will switch ends of the court between every game.
5. See attached rules for more details.

Team Uniform Contest – Prizes for Each Division!
Judged on Creativity, Team Spirit, Artistry, & FUN! Winners selected at discretion of local celebrity judges.

Sponsored by:
Participant's Name *
Your answer
Grade/Division *
Required
Parent's Email: *
Your answer
Team Name: *
Your answer
Phone: *
Your answer
Emergency Contact Name: *
Your answer
Emergency Contact Phone: *
Your answer
Medical Considerations/Allergies (please mark N/A if not applicable): *
Your answer
I agree not to hold responsible Ashland Youth Lacrosse; the Town of Ashland; the owners of the premises where the program is held; or any of the parties connected with the program for any injury or accident that may occur during the program. I understand that if my child becomes a discipline problem, he/she will be dismissed from the program and no money will be refunded. I also grant permission for the event staff to seek medical care for myself or my child in the event that a family member cannot be reached. *
Required
I give permission for any pictures taken of my child in this program to be displayed: *
PAYMENT INFORMATION:
1. Venmo: @Ash-Lax
2. PayPal (select 'Friends and Family' option): ayltreasurer@gmail.com
3. Check - Made payable to Ashland Youth Lacrosse and mail to Amy Westerlind, 202 Cross St, Ashland MA 01721

**Please remember that your team is not considered as fully registered until ALL members have completed their registration AND the team's fee has been paid!!**

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