Little Laxers Registration 2020

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Hello everyone!

Thank you for signing up for Little Laxers! We are excited to offer this introductory program to boys and girls in Kindergarten through 2nd grade. Please see additional details below. When you are finished filling this form out, please go back to www.glencoelacrosse.org and pay for the little laxers program. Each player will receive a stick and jersey on the first day of the program!

What: Little Laxers is a program to get kids moving and having fun learning the game of lacrosse. Each session the coaching staff will put the players through a variety of stations where they are taught the skills they need to be successful playing lacrosse. During the sessions tennis balls and other soft balls will be used. Players will not need lacrosse gear for these sessions.

When: April 4th - May 23rd (8:15am-9:30am)

Where: Hare Field (1151 NE Grant St. Hillsboro, OR 97124)

What should I bring? Players will need to bring water, athletic clothes, and athletic shoes or cleats. Please bundle up if the weather is not the best.

Cost: $60 (Payable at www.glencoelacrosse.org)

Thank you,
Kyle Tolzman
Little Laxers
Program Director
tolzmaky@hsd.k12.or.us

Liability Waiver

My child and I agree to abide by the following rules:
● Follow safety rules and other instructions provided by the activity instructors and coaches.
● Share responsibility for my personal safety and not endanger others who are participating in the activity.
● Immediately report all defective equipment and/or unsafe acts and dangerous conditions to the Camp Coach or Camp Staff.
● I acknowledge by attending the activity my child is encouraged to have a physical examination in advance and obtain adequate personal health and accident insurance prior to participating in the activity.
● In case of emergency, accident or illness, I give my permission for my child to be treated by a professional medical person and admitted to the hospital if necessary. I agree to be responsible for all medical expenses which are incurred.

I acknowledge that my child is participating at his/her own risk. I understand that there is a risk of injury in participating in Little Laxers, due to the inherent nature of the activity. By accepting this liability waiver below, I acknowledge that I understand this assumption of risk, agree to the conditions listed above, and will not hold Glencoe High School, Hillsboro School District, or Glencoe Youth Lacrosse or camp personnel liable.

Do you agree to the liability waiver above? *

Yes

What is the player's first name? *

What is the player's last name? *

What name does the player go by? *

What is the parent or legal guardian's first name? *

What is the parent or legal guardian's last name? *

What is the parent or legal guardian's email? *

Are there any other emails that need to be sent communications for this child?

What is the parent or legal guardian's phone number? *

Who should we contact in an emergency? *

Emergency Contact Phone Number? *

What is the player's birth date? *

YYYY

What grade is the player currently in? *

What school does the player attend? *

What is the player's gender? (Boys will be getting boys sticks and girls will be getting girls sticks) *

What size t-shirt does the player wear? *

What is the full name of the player's doctor? *

What is the phone number for the player's doctor? *

Who is the player's Insurance Provider? *

What is you Insurance Provider ID? *

Does your child have any allergies? If yes, please explain. *

Does your child have any medical conditions we should be aware of? If yes, please explain. *

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