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College Connections Lacrosse Clinic Sign-up
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PLAYER INFORMATION
Player First Name
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Your answer
Player Last Name
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Date of Birth
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YYYY
Grade Entering
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3
4
5
6
7
8
9/Older
Years of Experience
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Just Starting!
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Position
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Attack
Middie
Defenseman
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PARENT/ GUARDIAN INFORMATION
Parent's First Name
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Parent's Last Name
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Address
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City
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State
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Preferred Email Address
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Cell Phone
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EMERGENCY CONTACT INFORMATION
Emergency Contact First Name
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Emergency Contact Last Name
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Emergency Contact Number
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MEDICAL INFORMATION
Physicians Name
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Physicians Number
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Insurance Carrier
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Insurance ID Number
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Medical Concerns (Please respond "None" if there are no concerns)
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Session Sign-Up
Session(s)
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July 9 - 11
July 25 - 27
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