HURRICANES GIRLS LACROSSE CLUB
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PLAYER REGISTRATION FORM
Registration Period *
Required
Player Name *
Date of Birth *
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Graduation Year *
Name and Location (City) of School Player Attends *
Home Street Address *
City *
State *
Zip Code *
Home Phone
Player Cell Phone *
Player Email Address *
Parent Email Address *
U.S. Lacrosse Membership # (REQUIRED) 

Don't Know? Go Here:  USA Lacrosse Membership Lookup - https://memberlookup.uslacrosse.org

Don't Have One? Go Here: USA Lacrosse - https://usalacrosse.com
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U.S. Lacrosse Membership Expiration Date *
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Positions Played *
Required
# of Years Playing *
Parent/Guardian Name *
Cell Phone *
Parent/Guardian Name
Cell Phone
Other Emergency Contact *
Cell Phone *
Does your child have any medical concerns including, but not limited to: seizures, drug allergies, nose bleeding, unusual reactions to insect bites, asthma, or diabetes? *
If "Yes" or "Other", please explain below:
Does your child take any medications on a daily basis? *
If "Yes", please list below:
Dietary restrictions *
Preferred Player Number (NOT GUARANTEED)- Please put down up to 3 choices: *
Jersey Size 
Clear selection
Shorts Size 
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How did you hear about us? *
Were you referred by a current player? If so, who? *
PARENT OR GUARDIAN AUTHORIZATION TO PARTICIPATE
I understand that I/my child will not be covered by any program insurance and I agree that I will not hold the team, coach, or program responsible for any injuries received while participating in the HURRICANES GIRLS LACROSSE CLUB program. I also agree that I am responsible for the reasonable care and return of any equipment loaned to me by the program.
By typing my name below, I agree to the above statement. *
EMERGENCY MEDICAL RELEASE
I give permission for my daughter to receive emergency medical treatment by any qualified individual necessary either on the practice field or game fields. I hereby authorize and hospital and/or physician to perform emergency treatment for any injuries resulting from my daughter's participation in the HURRICANES GIRLS LACROSSE CLUB program. I understand that every reasonable attempt will be made to contact me before taking this action.
By typing my name below, I agree to the above statement. *
FEES, REFUND POLICY, AND FUNDRAISING
Completion of this form is necessary for any participant in the HURRICANES GIRLS LACROSSE CLUB. The total fee for Summer Participation is $900. The total fee for Fall Participation is $900. Total fee for Winter Indoor is $150, Payable to HURRICANES GIRLS LACROSSE CLUB. Any fees, or portion of any fees paid, are NON-REFUNDABLE as the team's league/games fees, uniforms, and other administrative and operational expenses are pre-paid in advance and non-refundable. Fundraising opportunities will be provided throughout the year. I understand that if my daughter participates in the fundraising activities, the funds raised by her will go directly towards reducing her registration fees. ALL PARTICIPANTS MUST HAVE A VALID USA LACROSSE MEMBERSHIP (USA Lacrosse Registration - Paid separately online at www.usalacrosse.com)
By typing my name below, I agree to all of the above statements and terms. *
Date of Registration *
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