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Player Registration for Girls & Boys Summer Training (KOP)

Please complete this brief form to register for Girls & Boys Summer Training (KOP).
*If you have a Mac computer you will need to download and install Firefox internet browser to register for any Laxevo event.
**Google Chrome Browser does not work on our site.
***All required boxes must be filled out, if not applicable to the event please enter N/A.

Step 1 - Player Info

Step 2 - Waiver/Release

Step 3 - Review/Submit

Section 1: player information.

Please complete the entire form to register for Girls & Boys Summer Training (KOP).

Player's Name:
Birthday:
Player Email:
Parent Name:
Parent Email:
Home Phone:	- -
Other Phone:	- -
Address:
City, State Zip:	,
Gender:	Male Female
Class:
Position:
Current School:
US Lacrosse Number: (required)
Shirt Size:
*answer below bullets that pertain to event How did you hear about us? Comments Roommate request Team name/Individual Day(s) Time(s)
Emergency Contact:
Emergency Contact Phone:	- -
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Section 2: to be completed in full by parent or legal guardian.

Medical Authorization: I understand that the Camp/Clinic will consist of physical activities, drills, and training, which may pose a risk of injury to the attendee, and I hereby knowingly and voluntarily assume on behalf of the attendee all risks and responsibilities for any such injury. I will be financially responsible for any medical attention needed by attendee during the event or resulting from any injury received at the event. My medical insurance shall be the primary medical insurance coverage for any medical treatment received by attendee. I represent and warrant that I have legal authority to sign this authorization on behalf of attendee.
Insurance Carrier:
Policy Number:
Policy Holder:
Policy Holder DOB:
Photo Release: I understand that �The Camp� retains the right to use for publicity and advertising purposes, photographs of individuals participating in the camp and do hereby consent to the use of such photos for such purposes by �the Camp�. I agree with the above disclaimer.
Waiver: I understand that the this event is directed by Lacrosse Evolution and I am fully aware of and appreciate the risks, including the risk of catastrophic injury, paralysis, and even death, as well as other damages and losses, associated with participation in a lacrosse event. I agree on behalf of the attendee, myself, my heirs and personal representatives, to release and agree to indemnify and hold harmless Lacrosse Evolution, officers, directors, employees and agents of Lacrosse Evolution, The Camp and any Camp sponsors, coaches, volunteers, employees, agents, officers and directors of these organizations from any damages, costs, or liability for any injury, illness or otherwise related to attendee�s participation in this event. I agree with the above disclaimer.
Signed:
Date:
Relationship to Attendee:
Initial:
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Section 3: review your input and submit the application.

Player Information:

Waiver/Release:

Camp fee due with registration: 200.00
I will mail a check I will pay online using Visa, MasterCard, or Amex

If you do not receive your confirmation right away please check your junk mail. To try and ensure reciept, a confirmation email will be sent to both email addresses you have provided.
Please type the above number in the field below:

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