LITTLE RHODY LACROSSE
Staff & Contact
2021 LITTLE RHODY LACROSSE CAMP - REGISTRATION & PAYMENT
Indicates required field
Age (as of 6/28/21)
Grade (entering Fall '21)
Other (Discuss with Director)
Not sure of position? No worries, LR Staff encourages participants to try different positions during camp!
0 Years (First-time Player)
4 or more Years
Home Phone Number
Parent Cell Number
Cell Phone for Text Alerts (if different from Parent Cell)
Insurance Policy Number
Participant Health Issues
Emergency Contact Phone
I represent that I am the parent and/or legal guardian of the child named below and hereby give my permission for my child to participate in any and all activities at the 2021 Little Rhody Lacrosse Camp "Camp" at Roger Williams University "University". I agree to assume all risks associated with my child's participation in the Camp including but not limited to sickness/illness, risk of bodily injury, death, and / or property damage. In consideration of my child being permitted to participate in the Camp, I agree to release, indemnify, and hold harmless the University & Little Rhody Lacrosse, LLC, its trustees, directors, officers, employees, students, contractors, volunteers, affiliates, and agents, from any and all claims that I or any third party might have as a result of my child's participation in the Camp. I give my consent for my child to receive emergency medical treatment in the event that my child becomes sick/ill or is involved in an accident during the Camp. I understand that I will be notified at the emergency telephone number provided on this form in the event of an emergency involving my child.
Waiver Approved By
By clicking SUBMIT button below, your registration information will be submitted and you will be directed to different page for payment instructions.
Payment can be made via credit/debit card (Visa, MasterCard, American Express or Discover) & Venmo.
If check needed for payment, please contact Coach Kelly at firstname.lastname@example.org.
Please note that spot in CAMP is not guaranteed until payment has been received.
Staff & Contact