NCS GIRLS LACROSSE MEDICAL PROVIDER COVERAGE
NCS APPROVED MEDICAL PROVIDER COVERAGE FOR THE 2024 NCS GIRLS LACROSSE CHAMPIONSHIP EVENTS.
SUBMISSION OF THIS FORM INDICATES THAT THE PERSON LISTED WILL ATTEND AND PROVIDE COVERAGE AT THE SCHEDULED 2024 NCS GIRLS LACROSSE CHAMPIONSHIP CONTEST.
THE MEDICAL STIPEND OF $90.00 WILL BE PAID DIRECTLY TO THE NCS APPROVED MEDICAL PROVIDER THROUGH THEIR ARBITERSPORTS ACCOUNT.
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ENTER THE DATE OF THE CONTEST *
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ENTER THE HOSTING SCHOOL NAME *
ENTER THE VISITING SCHOOL NAME *
ENTER THE NAME OF THE NCS APPROVED MEDICAL PROVIDER *
ENTER YOUR NAME AND POSITION *
A copy of your responses will be emailed to the address you provided.
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