Please complete all entries.
Name: Address: City: State: Zip: School: Phone: Email: Age: (if under 18) Sport: Emergency Contact: Contact Relationship:
Lacrosse (Session 2) "Pure Speed" $65.00
Speed Development Clinic $50.00
Competitive Edge (indicate session by choosing the amount below)
6 sessions $90.00
12 sessions $144.00
24 sessions $240.00
Print PAR-Q and Injury Waiver (both must accompany payment or first class)