Newport Harbor Lacrosse Registration
Only parents, legal guardians or persons 18 years of age or older can enter information for this program. If you are not at least 18 years old and you wish to register, you will need to have a parent or guardian fill in the following forms.

This program is restricted to participants within grades 9 to 12.
Student First Name *
Your answer
Student Last Name *
Your answer
Student Graduation Year *
Your answer
Student Email *
Your answer
Student Address *
Your answer
Student Phone number *
Your answer
Birthday
MM
/
DD
/
YYYY
Height
Your answer
Weight
Your answer
Please list any medical allergies or ailments you may have. If none, please type N/A. *
Your answer
Emergency Medical Contact Name *
Your answer
Emergency Medical Contact Relationship *
Your answer
Emergency Medical Contact Phone Number *
Your answer
Player Position
Your answer
Player Bio
Your answer
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