2017 MEDINA GIRLS LACROSSE CAMP

CAMP REGISTRATION INFORMATION  When: July 17, 2017 (Mon) – July 21, 2017 (Fri)  For Registration go to medinaathletics.com. Then go to the "Bees HQ" tab and then to 2017 summer camps. Please send any questions or

registrations to [email protected].

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Times: Where: Grades: Cost: Includes:

11:00 am - 2:00 pm MHS (TBD) Entering Grades 2nd thru 9th $90 (Checks made payable to Medina Athletic Dept.) Jersey, Water Bottles, Balls, & More!

Medina High School Varsity staff, college players, and current high school players from Medina, Brunswick, and Strongsville Lacrosse will be conducting a fun and competitive camp designed to improve individual skills and get a better understanding of the game of Lacrosse. Camp Information and Highlights  Learn the skills that it takes to play this fast paced and exciting game at    

the middle school and high school level . Designed specifically for girls entering grades 2nd - 9th in fall of 2017 Players from all area programs are Welcome! Skill contests with prizes EVERYDAY! Equipment available to borrow. Contact us early to arrange this.

For further information, please contact Coach Dan O’Brien at (c) 330-421-5267 or at [email protected]

Medina Girls Lacrosse Camp Player Information Name (Print)

Age

Address

Grade Entered this Fall City

Player’s Email

State & Zip

Parent’s Email (1) Parent’s Email (2)

Home Phone

School Attending in Fall 2016

Position(s)

# Years of Playing Lacrosse

Emergency Contact Information for Camp Mother’s Name

Daytime Phone Cell Phone Daytime Phone Cell Phone

Father’s Name

Name of relative, friend, or childcare provider to be notified if unable to reach parent: Name______________________________

Relationship

Address ____________________________

Daytime Phone____________________

Cell Phone ___________________

I, the parent of , a voluntary participant in this program sponsored by Medina Lacrosse, am aware that there are certain risks of injury involved. Bearing this in mind, and with full knowledge of physical capabilities or limitations of my child, I hereby agree to assume for my child such risk of injury. I further agree to indemnify and hold harmless Medina Lacrosse, Medina City School Board of Education and its employees and representatives against any claim for injury to persons or property, which may result from my child’s participation in this activity. Finally, I agree my child shall abide by the rules and supervision of Medina Lacrosse.

Parent or Guardian Signature

Date

Please mail this Camp Registration form and fee to (or bring it the first day of camp): Medina Athletic Department Attn: Girls Lacrosse 777 E. Union St. Medina, OH 44256