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LOWER MERION YOUTH GIRLS LACROSSE
1140 Springmont Circle, Bryn Mawr, PA 19010
www.lowermeriongirlslax.com
610-525-0775
2015 REGISTRATION FORM
Use one form for each individual player
The $150.00 ($100.00 for kindergarten, 1st and 2nd graders) registration fee (payable to LMYGL) must accompany this registration form
(please mail the registration and fee to: Richard Schwab, 1140 Springmont Circle, Bryn Mawr, PA 19010).
Grades Kindergarten-8 Eligible
Registration for Lower Merion Youth Girl’s Lacrosse will be held at the cafeteria at Harriton High School on Tuesday, February 24,
2015 (6:00 - 9:30 PM). You can either register by mail, on line (www.lowermeriongirlslax.com - you can also pay online) or register in
person on Tuesday, February 24, 2015. Either way you can come to the registration so that you can get a ball and mouth guard and we
can make sure your registration information is correct. Kindergarten and first graders should come to the registration between 6:00 6:30; 2nd graders should come to the registration between 6:30 – 7:00; 3rd graders should come to the registration between 7:00 - 7:30;
4th graders from 7:30 - 8:00; 5th graders from 8:00 - 8:30, 6th graders from 8:30 - 9:00; and 7th/8th graders from 9:00 - 9:30. If you have
more than one child you can register both at the same time (rather than coming to the registration twice). Kindergarten, first and second
graders will play on Sunday afternoons (1:00 - 2:30 PM) at Harriton High School. In-house games for 3rd - 6th graders will be held on
Sunday afternoons (1:00 - 5 PM) at Harriton High School with practices one night a week (Monday, Tuesday, Wednesday, Thursday,
you can pick the practice night). 7th/8th graders will practice on Monday nights and play games on Saturdays and Sundays. The lax
season will run from 3/29/15-5/31/15. There will also be “travel teams” for 3rd/4th and 5th/6th graders play on Saturdays. All participants
(including, kindergarten 1st and 2nd graders) will need to purchase standard lacrosse sticks and goggles.
Name of Registrant:_______________ ________________________Telephone:___________________________________________
Address:_________________________________________________ Grade (grades K-8 eligible):_____________________________
Town, State, Zip:_______________________________________ Birth Date (month, day, year):_______________________________
Parents’ Names:_______________________________________________________________________________________________
Emergency Contact and Phone: ___________________________________________________________________________________
Email Address (Print Carefully): ________________________________________________________________________________
Friends (2) you want to be on the same team with (only 3rd – 6th graders): ________________________________________________
Which night (s) can you practice: Monday, Tuesday, Wednesday, Thursday or any (only 3rd – 6th graders)? ______________________
Do you want to be a coach (training responsibilities)?
Yes __________; No __________
Do you want to be an administrative coach (training will be done by the high school players)?
Yes __________; No __________
RELEASE/AUTHORIZATION STATEMENT
Note: this statement MUST be signed by parent or guardian:
I, the parent/guardian of _______________________________________ hereby give my approval for her participation in the Lower
Player’s Name
Merion Youth Girl’s Lacrosse program. Recognizing the possibility of physical injury associated with lacrosse I hereby release, waive,
absolve, discharge and/or otherwise indemnify the LMYGL and their affiliated organizations and sponsors, their employees, coaches
and associated personnel, including the owners of fields and facilities utilized for the programs, against any claim by or on behalf of the
registrant as a result of the registrant's participation in the LMYGL programs, and/or being transported to or from the same, which
transportation I authorize.
Parent/Guardian Signature____________________________________________________Date_______________________________
Printed name of Parent/Guardian _________________________________________________________________________________