TRI TOWN LACROSSE Registration Form
3-ON-3 MINI GAME
Player's Name
First Name
Last Name
IF APPLICABLE - Player's - E-mail
example@example.com
IF APPLICABLE - Player's Phone Number
Please enter a valid phone number.
Parent #1 - Name
First Name
Last Name
Parent #1 - Phone Number
Please enter a valid phone number.
Parent #1 - E-mail
example@example.com
Parent #2 - Name
First Name
Last Name
Parent #2 - E-mail
example@example.com
Parent #2 - Phone Number
Please enter a valid phone number.
Player's Date of Birth
-
Month
-
Day
Year
Date
Player's Home Address
Street Address
Mailing Address
City
Province
Postal Code
Gender
Female
Male
Don't want to identify
Please upload photo of your health card here (mandatory)
Browse Files
Drag and drop files here
Choose a file
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of
Age Category (co-ed sport)
Please Select
Ages U7
Ages U9
Ages U11
Ages U13/U15
Do you have any pre-existing health conditions we should be aware of - including concussions from any other sports?
Yes
No
If you answered yes to health conditions - please describe here:
In any physical activity, the risk of serious injury is possible. The player and parents assume that risk for this activity and hereby release Tri Town Lacrosse Association and its volunteers and executive from any liability claims. Please indicate here you have read, understand, and agree with this statement:
Yes
No
Waiver of liability completed on this date:
-
Month
-
Day
Year
Date
Waiver of liability completed by this parent:
First Name
Last Name
Submit
Should be Empty: