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 Steps (to be completed in order!)

FIRST: Sign up with U.S. Lacrosse.
IMPORTANT! You must register online with U.S. Lacrosse to obtain your U.S. Lacrosse Number and Expiration Date. Follow the link below to join or to check the expiration date of your Membership.

http://www.uslacrosse.org

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

www.lasvegaslacrosse.org

THIRD: Sign up for Palo Verde Lacrosse.
Complete the Palo Verde Lacrosse Club 2012 Season Online Registration Here:

IMPORTANT! Players must complete the online registration with (1) Parent/Guardian. Be prepared to complete the form in one setting. It takes approximately 15-20 minutes to complete.

See the information below that you will need to be ready to provide.

Registration Dates

REGISTRATIONS BEGIN FOR ALL TEAMS ON DECEMBER 1, 2011. On-line registration will close March 31, 2012.

Due to team travel plans, all players for The High School Boys teams MUST REGISTER by JANUARY 10, 2012

Registration Costs

High School Boys D1 — Panthers

$350.00

High School Boys D2 — Panthers

$350.00

High School Girls — Panthers

$150.00

Middle School Boys — Rough Riders

$200.00

U.S. Lacrosse Registration Fee - High School

$35.00

U.S. Lacrosse Registration Fee - Youth

$25.00

Southern Nevada Lacrosse Association(SNLA) Fee

$130.00

Nevada Women's Lacrosse Association(NWLA) Fee

$???.00

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.

View 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*

Jersey Number

Additional Parent Information (optional)

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

First and Last Name

U.S. Lacrosse Number*

First and Last Name

U.S. Lacrosse Expiration Date*

Relationship to Player

Phone Numbers (Home or Cell)

Player's Medical Information / History

Email Address

Doctor's Name

Residence Address

Doctor's Phone

Employer Name

Hospital Name

Work Phone Number

Medical Insurance Carrier Name*

Medical Insurance Policy Number

Emergency Contact Information

Medical Insurance Group Number

Contact #1 Name*

Have Asthma Condition?*

Relationship to Player*

Have Epilepsy Condition?*

Phone Number*

Have reaction to Bee Stings?*

Alternate Phone Number*

List any other Known medical conditions

Contact #2 Name

List medications taking

Relationship to Player

List any activities that must be prohibited

Phone Number

Alternate Phone Number

If, for any reason, you are not able to complete the registration online, you may download the required forms from the Download Forms section of our site.

You must complete ALL of the following forms: Signup Application, Emergency Medical Consent, Waiver & Release of Liability, and Player's Rights and Responsibilities.

To register by mail now, first go to our Registration Forms download page via the link provided below. Download each of the (4) required forms. Complete the forms with at least one Parent/Guardian, and follow the mailing instructions below:

Registration Forms Download Page

Please make your check payable to: Palo Verde Lacrosse Club

Mail your signed and completed registration forms and check to:

Palo Verde Lacrosse Club
Attention: "PVLC Registration 2012"
P.O. Box 370696
Las Vegas, NV 89137