2024 Lacrosse Skills Training

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This is the participant registration form for the St. Philip's Complimentary Lacrosse Skills Training.
Dates: February 7th - May 11th
Days: Each Wednesday (5:30pm-7pm) and Saturday (11am-1pm)
Where: Athletic Field (If weather concerns, skills will be moved to the gym)
Scholars in grades 2nd - 8th are eligible to participate.
There is no participation fee for this clinic.  

Participant Information
*First Name
*Last Name
*Gender
 Male 
 Female 
*Grade
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*Date of Birth
Birth Certificate Submitted
  
*Street Address
*City
*State
*Zip Code
*School
*Jersey Size
Participant Medical Information
Please check any medical conditions that apply
 Convulsions 
 Epilepsy 
 Diabetes 
 Asthma 
 Hyperactivity 
 Hayfever 
Please list other Medical Conditions/Allergies
List any and all medications
Evidence of Medical Physical Submitted
  
Parent / Guardian 1 Information
*Guardian 1 First Name
*Guardian 1 Last Name
*Relationship
*Guardian 1 Email
Home Phone
Cell Phone
Work Phone
*Emergency Contact
*Emergency Contact Phone Number
*Volunteer hours you are able to provide?
Waiver
Waiver
I hereby grant permission to representatives of St. Philip's School & Community Center to provide care to my child in the event of injury or illness if I am not present.  Such care may include but shall not be limited to first aid treatment, transporting to a medical facility, or the summoning of emergency assistance.  I, the parent or appointed guardian of the above named child, hereby agree to indemnify and hold harmless St. Philip's School & Community Center and its officials, directors, managers, coaches and assistants from any liability for the above named child's activities of any nature with said organization.
*Waiver confirmation
 I have read and agree with the waiver. 
Refund Policy
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