Pick Up and Play Lacrosse Clinic
Sunday, November 3, 2024 from 1-3 pm at James Hite Park Kearneysville, WV
Player Name
*
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Current School (or Homeschool)
*
Grade
*
Any experience playing lacrosse? Choose all that apply.
*
None
Played in PE or with friends
Previously attended 1 or more clinics
Attended lacrosse camp
Have played on a team for one season
Have played on a team for 2 or more seasons
Other
Are there any medical / educational / special needs we should be aware?
*
Emergency Contact Name
*
Name
Emergency Contact Phone
*
Phone
Submit
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