Registration | Miller Girls Lacrosse Travel Team

Athlete's First Name *

Athlete's Last Name *

Athlete's Cell Phone *

Athlete's Email Address *

Athlete's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian First Name *

Parent/Guardian Last Name *

Parent/Guardian Email *

Parent/Guardian Cell *

Parent/Guardian Address (if different from yours)

Address Line 1

Address Line 2

City

State

Zip Code

Do you Wish to add a second Parent/Guardian Information?

Second Parent/Guardian First Name *

Second Parent/Guardian Last Name *

Second Parent/Guardian Email *

Second Parent/Guardian Cell *

Health Insurance Provider *

Health Insurance Policy Number *

US Lacrosse Number *

If you don't know your US Lacrosse Number you can visit US Lacrosse Membership Lookup

Date of Birth *//

School Name *

Graduation Year *

Try Out Date *

Camp Sessions

Sunday, 12/5 2:00-4:00

Sunday, 12/12 2:00-4:00

Sunday, 12/19 2:00-4:00

Cost

Session 1 $25

Session 2 $25

Session 3 $25

All 3 sessions $60

2021 Winter Camp Registration