West End Middle Blue Jays Boys Lacrosse

West End Middle Blue Jays Boys Lacrosse

Spring Season 2020
Team Registration:

1. Registration with US Lacrosse: A valid US Lax ID number is required for each player with a membership expiration date of after June 30, 2019. You must complete this step with US Lacrosse (www.uslacrosse.org) before submitting this web form. If your son played on the team last year, you do not need to complete this step and we we have his US Lacrosse Registration Number. You can leave this field blank on the registration form

2. Player Registration and Payment: Complete and submit this web form and complete payment via the PayPal link provided in registration email

Total Registration Fees: $165

*While electronic payments are easier from an administration standpoint, if this is not an option, please bring a check to practice made out to WEMS Lacrosse

Please contact Randy Brown at brown37205@gmail.com, if your child would like to play, but believe it would create a significant financial hardship for your family. We intend to do everything we can to offer this opportunity to all kids, regardless of their family's ability to play

3. Team Paperwork: Parents must complete and submit all required team paperwork online. Until those documents are completed, signed and submitted, your registration is not complete.

4. Please make sure that your child has a valid Sports Physical on file with West End Middle School. Physicals are valid for 1 year. Please provide a copy to Mr. Nettles, if you do not already have one at WEMS. We will use the required one from MNPS. If your child needs a participation physical, these can be completed at your pediatrician's office or any walk in clinic (including Kroger, Walgreens, CVS, etc). They will have the paperwork there.

If you have any questions about completing the online registration process or completing required electronic documents or payment, you can contact Bucky Harris at walter_r_harris@yahoo.com or (615)974-2062
Player Information
Player Full Name

First NameLast Name
US Lacrosse ID#
From www.uslacrosse.org
US Lacrosse Membership Expiration Date

MonthDayYear
Date
Grade in Current School Year
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState

Zip Code
Were you a member of last year's team?
Enter preferred uniform # (last year's players will get priority)
Uniform Size(*they run small)
Choose a size.
Shorts
Choose a size.

Parent 1 Information
Parent 1 Name

First NameLast Name
Parent 1 Email
Parent 1 Mobile Phone
Format: (000) 000-0000.
Please check boxes of areas that you would like to volunteer

Parent 2 Information (optional)
Parent 2 Name

First NameLast Name
Parent 2 Email
Parent 2 Mobile Phone
Format: (000) 000-0000.
Parent 2 Home Phone
Format: (000) 000-0000.
Please check boxes of areas that you would like to volunteer

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Relationship to Player
Emergency Contact Phone 1
Format: (000) 000-0000.
Emergency Contact Phone 2
Format: (000) 000-0000.

Informed Consent and Acknowledgement

I, the undersigned, hereby certify that I am the parent or legal guardian of the stated player below . I hereby give permission for the coaches of the West End Lacrosse Club to seek during Lacrosse activities, the appropriate medical attention for my child, for the medical attention to be given to my child, and for my child to receive the medical attention in the event of accident, injury or illness. I will be responsible for any and all costs of medical attention and treatment.

I, the undersigned, understand the Lacrosse (sport) is and activity, physical sport and that injuries can often occur during participation the sport. I also understand that there will be more players than coaches during practices, games and activities, and that my child cannot receive individuated attention and individualized supervision at all time. I hereby acknowledge that my child is physically fit and mentally capable of participating in practices, games, and other activities.

I, the undersigned, hereby acknowledge and understand that the West End Lacrosse is a club run sport and is not operated by West End Middle School, or the Nashville Metropolitan Government, but rather under the sole sponsorship, control and supervision of the West End Middle School (WEMS) Lacrosse Club. I waive, release, and forever discharge the WEMS Lacrosse Club, club personnel, volunteers, organizers, and any and all team or club representative, successors, and assigns, West End Middle School, and all Metro Nashville Government Entities from any and all liability claims, demands, actions, and cause of action whatsoever arising out of or related to any loss, personal injury, or property damage that may be sustained or occur during the participation in activities or while at engaged in Lacrosse activities or on School grounds.

I give permission for the West End Lacrosse Club to take photographs of my child while engaged in Lacrosse activities for the sole purpose of advertising and publicity, and I understand that my child’s identity will remain anonymous in conjunction with any photograph used in marketing.

My signature below indicates that I have provided true information and have read, understand and agree to all statements on this entire form and on any other form required by the Club.
Player's Name
*Note to e-sign, either hold the mouse down and write your signature or trace with your track pad
Parent/Guardian Signature

Submission
Should be Empty:

West End Middle Blue Jays Boys Lacrosse

Player Information

Parent 1 Information

Parent 2 Information (optional)

Emergency Contact Information

Submission