Girls Lax Clinic, offered by the Portland Women’s
Lacrosse Club
Two-day
clinic, March 3rd and 4th, at Lakeridge High School Saturday,
9:00am-4:00pm - Sunday, 9:30am-1:30pm $50.00, includes a ball and a
t-shirt BRING: stick, mouth guard, sack
lunch, H2O
ALL
LEVELS ENCOURAGED AND WELCOME!
Pre-registration
can be received no later than February 28, 2001.
Please
make check out to Portland Women's Lacrosse, and mail to:
-
Andrea
Shatz
-
1610
SE 47th Avenue
-
Portland,
OR 97215
Please
include:
Name,
address, lacrosse experience, SCHOOL, and preferred shirt size. SIGNED
WAIVER OF LIABILITY MUST BE INCLUDED WITH PRE-REGISTRATION, OR BROUGHT TO
FIRST DAY OF CLINIC. If
not pre-registered: Registrations
will be taken on Saturday, March 3rd from 8:30am-9am
Feel
free to e-mail me with any questions. Andrea
Shatz Portland Women's Lacrosse Club [email protected]
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WAIVER OF LIABILITY
In
consideration of participating in activities at the 2001 Portland
Women’s Lacrosse Clinic on March 3rd and 4th
2001, participants acknowledge that they are aware of the nature of
the activity, and that there are inherent risks in any such activity.
The Portland Women’s Lacrosse Club is waived from any and all
claims for personal injuries, loss of life, or other loss or damage
occurring as a result of participation in the activities.
Participants and/or parent or guardian of a minor aged 17 and
younger authorize members of the Portland Women’s Lacrosse Club to
seek medical treatment in the event of an accident or emergency.
_____________________________________
____________________________
Participant Primary Medical Insurance Carrier
Policy Number
______________________________
______________
____________________________
Signature of Participant
Date
Name of Policy Holder
FOR ANY PARTICIPANT WHO IS NOT YET 18 YEARS
OLD: As legal parent or guardian of this participant, I hereby verify
by my signature below that I fully understand and accept the above
conditions for permitting my child to participate in this event.
________________________________
_________________________
____________
Signature of Parent/Guardian
Print Name
Date
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