Westwood Youth Lacrosse April Vacation Clinic
Monday and Tuesday: April 15 and April 16, 9:00am - 12:00 noon
Grades 1-8. New players welcome. Program cost $35.00
Westwood High School, 200 Nahatan Street, Westwood, MA 02090
Players will need a stick, goggles, mouth guard, water and a healthy snack.
Clinic limited to 60 particpants: please register early, generally fills by April 13, 2017
Clinic Registration: 1. complete the information, sign the waiver below and mail to
Westwood Girl’s Lacrosse, P.O. Box 229, Westwood, MA 02090
2. Please make checks payable to Westwood Girl’s Lacrosse
Questions: 617-462-5590 kathleenkmcdonough@hotmail.com
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Home Phone:Emergency contact and phone:
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Health Insurance:Policy number:
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CONSENT TO PLAY AND LIABILITY RELEASE
I acknowledge that lacrosse is a high-speed sport which may involve some contact. I am aware of no medical conditions, illnesses or injuries that would prevent my child from participating in all aspects of this clinic except as follows (Please state the medical condition and provide a letter from the child’s health care provider indicating the limitations or restrictions for the child’s participation):
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I hereby give permission to provide emergency medical assistance to my child in case of accident or injury. I agree to indemnify and hold harmless Westwood Girl’s Lacrosse, any individual working as an officer, coach, employee, age agent or volunteer or in any capacity for this organization, for any and all injuries, damages, causes of actions or claims for personal injuries or property damage, arising from my child's participation in this program.
Signature of Parent/Guardian: __________________________Date: ____/____/____
