Palo Verde Lacrosse Club - Las Vegas Nevada

P a l o V e r d e L a c r o s s e . c o m — Registration Info & Instructions

Registration Dates

REGISTRATIONS BEGIN ON NOVEMBER 16, 2009 — REGISTRATIONS END ON MARCH 1, 2010

Late Registration:
THE REGISTRATION DEADLINE IS MARCH 1, 2010.
There is no late fee, but all players MUST be registered and PAID IN FULL by the March 1, 2010 cut-off date!

Registration Costs

High School Boys Division I — Panthers

$150.00

High School Boys Division II — Panthers

$150.00

High School Girls — Panthers

$145.00

Middle School Boys — Rough Riders

$130.00

U.S. Lacrosse Registration Fee

$35.00

Southern Nevada Lacrosse Association(SNLA) Fees:

SNLA Fee for High School Boys & Girls

$155.00 **

SNLA Fee for Middle School Boys

$90.00

Add Best of the West & Bonanza Jam Sign-up (optional)

$55.00

** Includes Best of the West & Bonanza Jam Sign-ups!

Registration Steps (to be completed in order!)

1) FIRST: Sign up with U.S. Lacrosse.
You must register online with U.S. Lacrosse to
obtain your U.S. Lacrosse Number and Expiration Date.

Follow the link below, then click on the red JOIN NOW button upper-right of the resulting page...

http://www.uslacrosse.org/membership/index.html

2) SECOND: Sign up with SNLA.
You also must register online with Southern Nevada Lacrosse Association (SNLA).

www.lasvegaslacrosse.org

3) THIRD: Sign up for Paloverde Lacrosse.
Complete the Palo Verde Lacrosse Club 2010 Season Online Registration Form.
Be prepared to complete the form in one setting.
It takes approximately 15 minutes to complete.

IMPORTANT! Players must complete the online registration with (1) Parent / Guardian . Below is a list of the information you will need to provide.

SIGN-UP HERE FOR SEASON 2010

Electronic Signature for Registration Forms

During registration, in the Waiver's section you will find four (4) important documents to read, acknowledge, and sign via legally-binding and valid electronic signature, provided for within the system.

Veiw or Download Registration Waivers

Player's Information

Guardian Parent Information

First and Last Name*

Phone Numbers* (Home or Cell)

Relationship to Player*

Email Address*

Phone Numbers* (Home or Cell)

Residence Address*

Email Address*

Gender*

Residence Address*

Birth Date*

Employer Name*

School Name*

Work Phone Number*

Grade*

Volunteer Positions Interested In

Jersey Number

Shirt Size*

Uniform Sizes* (Jersey, Shorts, and T-Shirt)

U.S. Lacrosse Number*

Additional Parent Information (optional)

U.S. Lacrosse Expiration Date*

First and Last Name

Relationship to Player

Player's Medical Information / History

Phone Numbers (Home or Cell)

Doctor's Name

Email Address

Doctor's Phone

Residence Address

Hospital Name

Employer Name

Medical Insurance Carrier Name*

Work Phone Number

Medical Insurance Policy Number

Volunteer Positions Interested In

Medical Insurance Group Number

Shirt Size

Have Asthma Condition?*

Have Epilepsy Condition?*

Emergency Contact Information

Have reaction to Bee Stings?*

Contact #1 Name*

List any other Known medical conditions

Relationship to Player*

List medications taking

Phone Number*

List any activities that must be prohibited

Alternate Phone Number*

Contact #2 Name

Relationship to Player

Phone Number

Alternate Phone Number