Utah County ASCENT

Player Name

First NameLast Name

Grade (26-27 School Year)

Which high school will you attend?

Which lacrosse league(s) have you participated in before? (select all that apply)

Player Position

Parent Contact Name

First NameLast Name

Parent Contact Phone

Format: (000) 000-0000.

Parent Contact E-mail

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

All players must have a current and active USA Lacrosse Membership to participate. You can find your membership number or purchase a membership at usalacrosse.com

USA Lacrosse Membership Number

Register with a friend to receive a FREE limited edition water bottle (both players must list each other on their registration)

Name of Friend

Participation Waiver

I understand that lacrosse is a physical sport that may result in injury. I consent for my child, named above, to participate in the Flex6 Lacrosse Camp and declare that we are participating at our own risk. We will not hold Utah County Lacrosse or any of the affiliated directors, coaches, and staff responsible for any injury that occurs while participating in our program. We will provide our own medical attention and treatment to our child if needed.

Signature

Program Fees & Payment Packages

Camp T-ShirtYou

Included with camp registration

Free Size

Summer Camp: All 4 Weeks

Jul 6 - 30 | Mon-Thurs 9-10:30am | Camp Shirt

$200.00

Summer Camp: Week 1

July 6 - 9 | Mon-Thurs 9-10:30 AM | Camp Shirt

$55.00

Summer Camp: Week 2

July 13 - 16 | Mon-Thurs 9-10:30 AM | Camp Shirt

$55.00

Summer Camp: Week 3

July 20 - 23 | Mon-Thurs 9-10:30 AM | Camp Shirt

$55.00

Summer Camp: Week 4

July 27 - 30 | Mon-Thurs 9-10:30 AM | Camp Shirt

$55.00

Stick Rental

Must be returned at the end of registered session(s)

$25.00

Enter coupon

Total

Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info

Utah County ASCENT

Program Fees & Payment Packages*

Payment Methods

Program Fees & Payment Packages