BRITISH COLUMBIA LACROSSE ASSOCIATION
Senior Practice Registration Form
For Practice Purposes Only
League
Division
Team
Team Played for (last season)
Name of Player
Address:
Street
Street
City/Province
P.C.
Phone:
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Medical Plan Name
Identification #
Date
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Player's Signature (Parent if under 19)
For Club Use Only:
Fee
Fee
Paid
Date
Signature of Secretary/Registrar
Submit
Should be Empty: