Transcript Document
LEVITTOWN SEAFORD WANTAGH ATHLETIC ASSOCIATION
INCOMING K THRU 8TH GRADERS
Varsity Lacrosse Coaches from
MacArthur, Division, and Bellmore JFK High Schools
Chris Bergersen, John Nessler, Glenn Cocoman, Jim Kern, & Craig Papach
July 13th thru July 17th 9 AM to 12:00 PM
@ MacArthur High School
$100.00 per attendee for K – 2nd Grade!
$125.00 per attendee for 3rd – 8th Grade!
Have fun and please remember to pack plenty of fluids and a lunch!!!
Make check payable to:
LSW @ PO BOX 243 Wantagh, NY 11793 or
Pay Online @ www.LSWBB.COM using Pay Pal
-Campers must provide own lacrosse stick
-Some helmet availability, based on a first come, first serve basis.
-Special guests and sponsors throughout the week.
NAME:________________________________________________________________________________
ADDRESS:____________________________________________________________________________
PHONE #:_____________________ALT#____________________EMAIL:________________________
SCHOOL (Fall 07'):____________________________________T-SHIRT SIZE:___________________
Any questions, Call (516) 616-3107
Waiver
I know that participating in the LSWAA Lacrosse Clinic (the "League"), is a potentially hazardous activity. I agree not to
participate unless I am medically able and properly trained. I am voluntarily participating and assume all the risks associated
therewith including but not limited to falls, contact with other participants, spectators, or others and the condition of the fields, all
such risk being known and appreciated by me. Having read this Waiver and knowing these facts, and in consideration of the
acceptance of this registration I, for myself and anyone entitled to act on my behalf, to the fullest extent permitted by law, waive
and release the LSWAA Lacrosse Clinic, its affiliates, officers, directors, employees, and agents, and their heirs, representatives,
successors and assigns from present and future claims and liabilities of any kind, known or unknown, arising out of my
participation in the League or related activities, even though such claim or liability may arise out of negligence or fault on the part
of any of the fore-going persons or entities.
Participant's Name (Printed): ___________________________________
Parent/Guardian Signature: ________________________Date_________