Warwick Girls Youth Lacrosse Registration - Spring 2020
Player's Name *
First and Last Name (ex. John Smith)
Your answer
Player's Grade *
For the 2019-20 School Year
Player's School *
For the 2019-20 School Year
Player's Birth Date *
MM
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DD
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Parent's Name(s) *
(Ex. John and Jane Smith, or John Doe and Jane Smith)
Your answer
Parent Primary Email Address *
Used for club and team communications. We do not share email addresses with outside organizations.
Your answer
Additional Parent Email Address
Not required - but will also be included in club and team communications
Your answer
Primary Contact Phone Number *
Ex. 123-456-7890
Your answer
Additional Contact Phone Number
Ex. 123-456-7890
Your answer
Player's Primary Residence Street Address *
Your answer
City, Zip Code *
Ex. Lititz, 17543
Your answer
Emergency Contact Name & Relationship to player *
Ex. John Smith - Father
Your answer
Emergency Contact Phone Number *
Ex. 123-456-7890
Your answer
Player's Insurance Carrier *
Your answer
Player's Insurance Policy/ ID Number *
Your answer
Does your child have any medical conditions we should be aware of? If so, please explain. *
If none, enter none
Your answer
US Lacrosse Number *
US Lacrosse Membership must be valid through May of 2020
Your answer
US Lacrosse Expiration Date *
US Lacrosse Membership must be valid through May of 2020
MM
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DD
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YYYY
Warwick Lacrosse Waiver
I verify that my child is physically able to fully participate in the Warwick Girls Lacrosse Club Spring 2020 Season. I agree to assume all risks resulting from my child's participation in the Spring 2020 LAGLA League and all activities sponsored by the Warwick Girls Lacrosse Club. I further agree that the Warwick Girls Lacrosse Parents Club, coaches or volunteers shall not be liable for any injury, harm or illness resulting from my child's involvement in the program. I understand in the event of a medical emergency I will be notified as soon as possible. I understand my child will receive first aid and medical attention at the discretion of the coaches and staff. I hereby give my permission for my child to be transported by EMS to the nearest hospital in the event of an accident. Parents, please type your name below acknowledging consent to this waiver statement:
Parent's Name *
for Warwick Lacrosse Waiver Consent
Your answer
Click the SUBMIT button below to complete your registration
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