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2021 ICE Member Information Form
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* Indicates required question
Player Information
for College Coach Roster Book
Player First Name
*
Your answer
Player Last Name
*
Your answer
Player Graduation Year
*
Choose
2022
2023
2024
Player Position
*
Choose
Attack
Midfield
FOGO
LSM
Defense
Goalie
High School Lacrosse Program
*
Your answer
Your Address
*
Your answer
Your City
*
Your answer
Your State
*
Choose
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Your Zip Code
*
Your answer
Player Contact Information
Player Nickname (What do you want to be called?)
*
Your answer
Player Email
*
Your answer
Player Cell Phone #
*
Your answer
Primary Parent / Guardian Contact Information
Primary Parent / Guardian Name (First, Last)
*
Your answer
Primary Parent / Guardian Email
*
Your answer
Primary Parent / Guardian Cell Phone #
*
Your answer
Secondary Parent / Guardian Contact Information
If none, please put "N/A"
Secondary Parent / Guardian Name (First, Last)
*
Your answer
Secondary Parent / Guardian Email
*
Your answer
Secondary Parent / Guardian Cell Phone #
*
Your answer
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