NJ Lacrosse Training

EmailMeForm

Players Name *
First Last
Email Address *
Date of Birth *
MM / DD / YYYY
Mailing Address *
Address Line 2 *
State *
Zip Code *
Phone *
### - ### - ####
Registration type *

Youth (3rd-8th Grade): 9am -Noon

High School: Noon - 3pm
Team(s) *

What team(s) does your son play for?
Grade *

Players Grade in Fall 2012
Position *

Attack

Midfield

Defense
Do you take Faceoffs? *
Years Of Experience *
US Lacrosse Number *

(Log onto www.uslacrosse.org to register if you do not have a USL number)
Pinny Size *
Emergency Contact Name *
Emergency Contact Number *
### - ### - ####
I certify that my son is physically capable to compete in lacrosse related activities. I understand the physical demands of the sport of lacrosse and by agreeing below give him my permission to participate in the NJLT 2012 Summer Lacrosse Camp. *

Yes, I Agree
Additional Information

List any allergies, or other information NJLT needs to know.