LacrosseRegistration

Lyndhurst Golden Bears Lacrosse Club

2022 Lacrosse Registration
Player Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number *
Please give us the best number to reach a parent/guardian in case of emergencies or practice changes/cancellations.
Email*
example@example.com
Grade Level*
US Lacrosse Number
US Lacrosse Expiration Date

MonthDayYear
Date
Uniform Size*
(uniforms run small, especially with equipment, order a size or two up)
Jersey Number 1st Choice
Jersey Number 2nd Choice
Primary Contact (Parent/Guardian)*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Secondary Contact (Parent/Guardian)

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Waiver, Release and Code of Conduct

Please make sure parents and athletes read and understand the following information:
Parent Signature*

Clear
Athlete Signature*

Clear
Fees and Payments

Cost: $150 per player which includes a jersey and shorts. Athletes must also have a valid US Lacrosse membership which can be purchased for $30 a year at USLacrosse

Make checks payable to: GOLDEN BEARS LACROSSE BOOSTER CLUB

Online payments coming soon!
Should be Empty:

Lyndhurst Golden Bears Lacrosse Club