2014 Hooch Lacrosse High School Summer Camp Registration Form

2014 Hooch Lacrosse High School Boys' Summer Camp
Dates: June 16-19

Location: CHS Turf

Time: 5-8:00pm (rising 9th-12th)

Equipment Required: Helmet, Mouth Guard, Stick, Gloves, Shoulder Pads, Elbow Pads, Water
Camper INFORMATION:
Child Name

First NameLast Name
Birth Date

MonthDayYear
US Lacrosse Number
US Lacrosse Expiration Date

MonthDayYear
Grade
Position
Years Played
Rising Grade
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mother's Cell Number

Area CodePhone Number
Father's Cell Number

Area CodePhone Number
Mother's Email
Father's Email
Player's Email
Release and Waiver of Liability (Please read and Sign Below)

The undersigned hereby and acknowledges that participation in this camp and related activities involves an inherent risk of physical injury, and teh undersigned, on behalf of the registrant, hereby assumes all such risk and does hereby release and forever discharge the camp and all the employees and agent thereof from any and all liability of whatever kind or nature, arising and by reason of any and all known and unknown, foreseen bodliy and personal injuries, damage to property, and the consequences thereof, resulting from this registrants participation in and or involvement with this camp including any failure of equipment or defect in the premises.

No refunds will be given
Parent Signature
Should be Empty:

2014 Hooch Lacrosse High School Boys' Summer Camp