Averill Park Youth Lacrosse Club

Players 2023 US Lacrosse Number:

* Player's First Name:

* Players Last Name:

* Date of Birth:

* Gender:

Male

Female

* Home Email Address -PLEASE take care when entering-:

* Street Address:

* City:

* State:

* Zip code:

Country:

* Parent/Guardian First Name:

* Parent/Guardian Last Name:

* relationship to player:

parent

guardian

* Parent/Guardian phone:

* guardian email:

* Home Phone # to reach Parent/Guardian:

* US Lacrosse Enrollment Form & Member Agreement:

I have read and agree to the US Lacrosse Enrollment form & member agreement in the handouts section of this website

* Medical Release:

I have read and agree to the medical release form in the handout section of this website

* Photo Release Form:

I have read and agree to the photo release form in the handout section of this website

additional comments:

* School Grade level of Play:

* Player T-Shirt Size:

* Player Jersey Size:

Youth Small

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult XL

Adult XXL

* Player Short Size: