SportsForms

Meadville Lacrosse Player Registration

2023 Season

Preview Data

Player Information

Player Full Name*

Name Player likes to be called (if different from above)

Date of Birth*

Player Mobile Phone

Player text messages allowed?*

Yes

Player Email

Player Grade*

School Name*

USA Lacrosse Number*

This is required. To join or renew membership, please visit www.usalacrosse.com before completing this form.

Player Address*

Where was player born?*

Has player obtained ITC from US Soccer?*

Yes

Year player moved to the US*

Player's age when moved to US*

Parent 1 Information

Parent 1 Name*

Parent 1 Email*

Parent 1 Mobile Phone*

Parent 1 text messages allowed?*

Yes

Parent 1 Home Phone

Parent 2 Information

Parent 2 Name

Parent 2 Email

Parent 2 Mobile Phone

Parent 2 text messages allowed?*

Yes

Parent 2 Home Phone

Emergency Contact Information (Other than a Parent/Guardian)

Emergency Contact Name*

Emergency Contact Relationship to Player

Emergency Contact Phone 1*

Emergency Contact Phone 2

Team Information

Team Selection*

Primary Position Played*

Secondary Position Played*

Other Player Information (If an ODP Player, please list what level.)

Jersey # First Choice*

Jersey # Second Choice*

Jersey # Third Choice*

Jersey # Fourth Choice*

Jersey # Fifth Choice*

Medical Information

Medical Conditions

Allergies

Physician Name*

Physician Phone*

Insurance Company*

Insurance Policy Number*

Payment Information

Based on your team choice, the total amount due is $.

Would you like to make a single payment or pay installments over time?*

Single

Multiple

Frequency*

After clicking SUBMIT below, your player documents will be generated and you'll be given the option to complete the documents immediately or have them sent to your email address for later completion.

I agree to terms & conditions.*