LC REGISTRATION

ALL PLAYERS & PARENTS MUST COMPLETE THIS FORM IN ORDER TO PLAY

* Indicates required field

PLAYER'S NAME *

First

Last

GENDER *

Male Female

SELECT THE PLAY DAY FOR YOUR CHILD *

PICK A TIME (Morning time available for weekends - Afternoon for weekdays) *

MY CHILD IS A... *

PLAYER'S DATE OF BIRTH *

PARENT OR GUARDIAN NAME *

First

Last

ADDRESS *

Line 1

Line 2

City

State

Zip Code

Country

PHONE NUMBER *

EMAIL ADDRESS *

ALL PARETS MUST PRINT, FILL OUT, AND BRING THE INSURANCE WAIVER ON THE FIRST DAY OF CLASS.