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Equipment Loaner Questionnaire
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* Indicates required question
Parent Name (First and Last)
*
Your answer
Address (Include: Street, City, Zip)
*
Your answer
Phone Number (Include Area Code)
*
Your answer
E-mail address
*
Your answer
School District you reside in (Not the school your child goes to)
*
Spring-Ford
Pottsgrove
Pottstown
OJR
Methacton
PV
Phoenixville
Souderton
Upper Merion
Norristown
Other
If "Other" what is the School District
Your answer
Child's Name (First and Last)
*
Your answer
Child's Gender
*
Boy
Girl
Other
Current Grade
*
K
1
2
3
4
5
6
7
8
Current Age
*
Your answer
Height (In Feet and Inches)
*
Your answer
Weight (in Pounds)
*
Your answer
Is this their first year playing organized lacrosse?
*
Yes
No
Do you have other children that will be playing and need equipment?
*
Yes
No
For what events/seasons do you need equipment (Select all that apply)
*
Back 2 Basics Fall Academy
Back 2 Basics Winter Academy
Spring-Ford Youth Lacrosse - Spring Season
Back 2 Basics Summer Camp
Other
Required
If "Other" please indicate what event you need equipment for.
Your answer
What pieces of equipment will you need (Please check all that apply)
*
Helmet - Boys
Shoulder Pads - Boys
Elbow Pads - Boys
Gloves - Boys
Stick - Boys
Stick - Girls
Goggles - Girls
Required
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