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Put Your Registration Hold # Here (By Invitation Only)
Returning Participants
Personal Lacrosse Information
As we already have your NAME , ADDRESS , PHONE , EMAIL, HEIGHT, WEIGHT,
Name:
Field Position:
I Plan on Playing in: (check all that apply)
Showtime! Indoor (Season runs through Fall & Winter)
Summer Outdoor
I Play a 2nd Sport in the: (check all that apply)
Fall Winter
Already on a Club Team?:
Yes
Writing Hand: Right-Handed Left-Handed
Strong Lax Hand: Right-Handed Left-Handed
Both-Hands
Height:
Weight:
Years You Have Played:
School You Attend:
Graduation Year:
Most Recent Playing
Starter, 2nd, 3rd:
Personal Contact Information
Date of Birth:
Primary Parent Day
Primary Parent Night
Home Phone Number:
Personal Cell Phone:
Street Address:
City:
State:
Zip Code:
E-mail Address:
Primary Parent e-mail:
Parent / Guardian Name:
Referred By
Please check every box
NBC Sports Broadcast of NLL All-Star Game
MIAA / University Lacrosse "LAX UNDER THE LIGHTS"
"LAX WRAP" with Brian Kroneberger T.V. Broadcast
A Coach Who?
Other Who?
e-mail of NBC Sports Promo
Found University on the Web
Name & Email of Player
Offer does not apply when
Special Requests: We will honor all 'special
I Would Like To
Player Name:
Phone / e-mail:
IMPORTANT Please note: When you click the Submit button immediately below, 1. YOU MUST CLICK THE 'SUBMIT' BUTTON TO SEND IN
