www.LuckyLax.com

“Your Premier Lacrosse Provider”

2008-2009 Indoor Girls League Session 1&2

Sign up for 2 Sessions of Indoor Lacrosse with Lucky Lax!  Pre-Game Clinic back by popular demand!

Pre-Game Clinic:  10/27/08 6:30-8 This 90 minute optional training session is designed to prepare players for the Session 1 "Get into the Game" league.  If you are new to the game and want to learn the basics or want to brush up on your skills.  This session is for you!  Strategy, stick skills, offensive and defensive moves will be taught.  Bring your stick, mouth guard and water bottle. $12 per player (be sure to circle this option on the form below)

Cost: $125 per League Checks written to LUCKY LAX

Game Location: Field Sports at  Sports Ohio 6400 Dublin Park Drive • Dublin, Ohio 43016 *Additional directions are posted at www.luckylax.com

Equipment:  Sticks, mouth guards, and eye-gear are required to participate.  Water bottle recommended.  All jewelry needs to be removed before playing. 

How to sign up:  Please complete Registration form below, include payment (checks written to LUCKY LAX) and Mail to: Lucky Lax, 5806 Killiney Lane, Dublin, OH 43016

*$30 fee for returned checks Refunds are not issued once League has begun.

                                                                                              2nd Session Deadline 12/18

Questions?  Feel free to email Trish Sullivan or Catherine Shelley with any questions you may have at

luckylax@hotmail.com;      Refer to our website for further contact information. 

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League Choice: Please Circle Choice(s): A) Varsity Session 1 $125   B)  JV Session 1 $125    C) 5th & 6th Grade Session 1$125  D.)  7th & 8th Grade Session 1 E.) Varsity Session 2 $125  F.) JV Session 2 $125  G.) Middle School Session 2

Player’s name: ___________________________________________ Date of Birth: _________ grade: _______

Address: ________________________________________________ city: ____________________

state: ______Zip code: _____________ phone 1: ______________________

Player’s email:  please PRINT clearly________________________________

Previous lacrosse experience: (middle school;   JV;   Varsity) _________________________ position: ______________________ 

School currently attending: _________________________________ Graduation year ____________

Parents name: ____________________________________________

Parent’s e-mail: please PRINT clearly_ ______________________________

Emergency contact: _________________________________phone: _______________________________

League T-shirt size (please circle):      S      M     L     XL

How did you hear about us?_____________________________________________

US Lacrosse #________________________________________________________

US Lacrosse provides Insurance to the players during activity.  Register at www.uslacrosse.org.  Membership is needed to play in Lucky Lax leagues.

Waiver:

This is to certify that I, as parent/guardian with legal responsibility for my minor child or ward, acknowledge that my child or ward will be engaged in activities that involve risk of injury at Field Sports Inc. and/or Sports Ohio, Inc., and I do recognize and assume all risk, whether foreseeable or unforseeable, on behalf of my child or ward, and consent on behalf of my child or ward, in connection with participation in activities or recreation and instruction at Field Sports Inc.  On behalf of my child or ward and his/her legal representatives, I hearby release and agree to indemnify Field Sports Inc., their affiliates, administrators, directors, agents, coaches and their employees, other participants, and sponsor agencies, from any and all claims and damages relating to or arising out of my child’s or ward’s involvement or participation in the programs at Field Sports Inc.

Parents name: ______________________________

Signature: _________________________________                                Date: ______________

In connection with the Applicant’s participation in Lucky Lax  Leagues, the undersigned do

certify that the Applicant/player is in good health, has no physical impairment restricting him or her from playing lacrosse, except as herewith provided in writing to Lucky Lax, and otherwise is able to participate in the program activities. We (are, are not please circle) attaching a statement explaining special physical limitations and/or required medication, if any, (please indicate if the Applicant/player suffers from allergies, asthma, diabetes, restricted activities, etc.). In further consideration of Lucky Lax acceptance of this application, the undersigned, both for himself or herself and on behalf of any minor child for whom he or she is submitting this application, hereby agree(s) to indemnify and hold harmless, Lucky Lax, its officers, directors, coaches, staff, workers,

volunteers, agents, and sponsors from and against any and all liability, claims, actions, lawsuits, losses,

judgments, and demands whatsoever, in law or in equity, arising out of or in any way relating to the Applicant’s participation in any League event, including, but not limited to, personal injuries or injury to property sustained or caused by the Applicant during or as a result of participation by the Applicant in Lucky Lax, Inc. The

Applicant is aware of the fact that lacrosse is a physically demanding and challenging sport in which injuries may occur.

I authorize LUCKY LAX, Inc., and its agent’s permission to request medical treatment as necessary to insure the well being of the applicant.______________(Please Initial)

Parents name: ______________________________

Signature: _________________________________               

Refunds are not issued once League has begun.