South River Girls Lacrosse Camp

Learn from the South River Coaches and 2015 Varsity Lacrosse Players!

Date: July 13-16
Time: 8 am - 11 am

Cost: $125 - Please make your checks out to “South River Girls Lacrosse” and send

to David Klingel: 201 Central AVE, East Edgewater, MD 21037 by July 8th.

Ages: 6 – 13 (Kindergarten – Eighth Grade)

Levels: Beginner – Advanced (girls will be grouped by age and experience). We have loaner equipment for beginners.

Location: South River High School on the Bermuda fields located behind the school.

Address: 201 Central AVE, East Edgewater, MD 21037.

Registration: Send emergency form in with your check. Please plan to arrive between 7:30 am – 7:45 am on Monday, July 13th.

Questions: Varsity Head Coach Caroline Cochran: CCOCHRAN@aacps.org

Girl’s Lacrosse Emergency Contact Form

Player Information: Grade/Age_____________________________

Name_________________________________________________________ Experience ___________________________

Home Address­________________________________________________________________________________________

Home Phone__________________________________________________________________________________________

Email__________________________________________________________________________________________________Person to Contact in case of Emergency:

Name______________________________Phone________________________Relation___________________________

Name______________________________Phone________________________Relation___________________________

Primary Care Physician:

Name________________________________________________Phone___________________________________________

Please list any medical conditions, medications, or allergies we should be aware of:

______________________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________________

Parent/Guardian Statement: I understand and accept that there are risks of serious injury and death in any sport. I hereby give permission for my child to participate in this activity. I hereby authorize medical treatment and/or transportation to a medical facility for any injury illness deemed urgently necessary by a licensed trainer, coach, or medical practitioner. In case of injury, I do not hold South River High School, its coaches and players, or the Anne Arundel County School District responsible.

Signed: ______________________________________________________ Date: ­­­­­­­­­­­­­­___________________________

Parent/Guardian

Youth Sizes Adult Sizes

T-shirt Size (circle): YS YM YL S M L XL

Loaner Equipment