MS Summer 2024 Registration

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Fall 2024
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Middle School Registration Form

Player Information

Player's First Name

Player's Last Name

Birthday

Player Email (Optional)

School

Graduation Year

Address

Lacrosse Experience Level

Position(s)

Attack

Midfield

Defense

Goalie

New Player

Player health conditions

Asthma

Allergy (anaphylactic)

Diabetic

Heart condition

Seizures

Other

Parent Contact Information

Parent's name

Parent's Email

Parent's Phone

Consent & Liability Release

I have read and agree to the release of liability and waiver form as it relates to my daughter (specified in entry one of this registration form) .View release of liability

Parent Signature

Referred to us by a friend? Let us know who!

Selection & Payment

Make your selection for payment *

Practice only - $150

Thanks for joining Pulse Lacrosse!

Watch your email for more information to be sent out prior to first practice.

Email us at: northernkentuckypulse@gmail.com

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