Players Name: 

Grade:

School:

 

Parent Information: 

Mother’s Name:   

Contact Information:

Father's Name: 

Contact Information:

Email: 

Emergency Contact:

Medical Conditions:

 

Please mail form and check payable to:

Rye Neck Girls Lacrosse

300 Hornidge Rd

Mamaroneck, NY 10543

Return checks by: February 26, 2024

 

As a parent or guardian of the applicant, I hereby accept the condition of enrollment and give permission for my child to participate in the Rye Neck Lacrosse Clinic. I agree to comply with all program regulations, and hereby remove the school and staff, from any and all liability for injury or damages incurred while involved in this clinic.

Parent Signature:

Date: