SUMMER LAX
Skills Development to include:
SHOOTING DODGING FEEDING TEAM OFFENSE SLIDE PACKAGES TEAM DEFENSE CLEARING PACKAGES
B R AV E H E A R T L AC R O S S E CLUB, LLC - Junior Program
Coaches:
•Rick Beltz •Bob Phillips •Andy Tamayo •David Webster
2009
•Others, TBA
P r a c t i c e s : M o n d a y s & We d n e s d a y s 6 - 8 P M @ L H P S S t a d i u m F i e l d 5 / 18 - N o l a t e r t h a n 6 / 2 2
$260.00 Club Fee Includes:
All Tournament Fees Uniform All other Fees included
TOURNAMENTS:
Wounded Warrior Project 5/30 & 5/31 Boca Blast 6/6 One TBA
Two Teams:
U15 - Player cannot turn 16 Yrs. of age in 2009. May not have played in a game as a member of a high school team (Varsity or Junior Varsity). U-13 - Player cannot turn 14 Yrs. of age during 2009.
The Junior Braveheart Program is open to all players who have not yet participated on
EITHER a JV or Varsity high school team. You must be a member of US Lacrosse to participate. Go to www.uslacrosse.org to join.
Sign - up Sheet & Waiver PERSONAL INFORMATION:
Name:________________________________________________Current Age________ Grade________________ Address:_________________________________________City:______________________Zip_________________ Home Phome (______)__________________ Cell Phone (_______)___________________ email:__________________________________________________ Date of Birth____________________________ Parent/Guardian Name:___________________________________email:__________________________________ Your School:_________________________________________
LACROSSE INFORMATION:
Position:______________________________Right/Left hand:___________________ Ht./Wt.:_________________ Did you play Varsity in your most recent season played? (Y/N)____ Junior Varsity ?(Y/N)_____ US Lacrosse #______________________________ Uniform Size: Jersey Shorts S S M M L L XL XL
Agreement to Participate in the program:
Braveheart Lacrosse Club
Risks Assumed: You, the Participant and/or Parent/Guardian, must read carefully and sign this Agreement. By signing this Agreement you acknowledge your understanding of the inherent dangers of playing, practicing, participating in tournaments, leagues, games and related activities for the sport of lacrosse and this program. This sport is a full contact sport and each time you step on the field, you run the risk of injury, including spinal injury, brain damage, broken bones, injured joints, neck injuries, serious damage to internal organs, all of which may lead to permanent impairment or death. With these kinds of injuries, you may seriously limit your ability to earn a living and engage in a normal life. You understand and assume these risks by participating in this program. Hold Harmless: In consideration of permitting you to participate in this program, you agree to hold Braveheart Lacrosse Club LLC, its owners, coaches, trainers, participants, suppliers, field owners, and volunteers harmless from any and all liability, cause of action, debts, claims, or demands of any kind which may arise by or in connection with your participation in the program. Release of Liability: This Agreement shall serve as a release of liability and assumption of risk by you, your heirs, estate, executor, administrator, assignees, and for members of your family. Release for Treatment: You hereby give us your permission to carry out diagnostic and therapeutic procedures as may be necessary, including procedures at a hospital or emergency care facility. Agreed: Agreed: _______________________________________ Parent/Guardian Date:__________________________________
__________________________________ Participant Date:_____________________________
Payment: Please mail checks payable to BRAVEHEART LACROSSE CLUB, c/o Bob Phillips 4438 Virginia Dr., Orlando FL 32814