Bethany Women's Lacrosse Summer Clinics Registration

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Email address *

First Name *

Last Name *

Address *

Phone Number *

High School

Club Team

High School Graduation Year *

Position

Interested Major:

Tune Up Clinic - Bethany, W.Va. *

$30 per session or $100 for all four

January 20, 2019 (1-3 p.m.) January 27, 2019 (1-3 p.m.) February 3, 2019 (1-3 p.m.) February 10, 2019 (1-3 p.m.)

Current Colleges Attending: Chatham and Wheeling Jesuit

OPEN TO 9th-12th GRADE PLAYERS

Method of Payment *

Cash Check

Please make checks out to 'Bethany College Women's Lacrosse' and mail to:

BETHANY COLLEGE Women's Lacrosse
31 E CAMPUS DR
BETHANY, WEST VIRGINIA 26032

*Payment also will be accepted at registration on the day of the event

Other comments/needs/medical concerns

General Release: I hereby release and waive any possible claim against Bethany College, Bethany Women's Lacrosse and its staff, and any other persons associated with the clinic or any and all damages, injuries, and/or lose of equipment that my child may sustain in the course of the program or while traveling to or from the clinic.

ELECTRONIC SIGNATURE

Parent/Guardian Full Name *

Date *

* required field