Individual Player Information : 2008 Club National Championship
Player First Name:
Player Last Name:
Team Name :
Baltimore Blaze
Brick Bandits
Carolina Fever Select Blue
Carolina Fever Select White
Central Jersey Select 2009
Central Jersey Select 2010
Central Jersey Select 2011-12
Central Jersey Select 2012/2013
CheckHers Elite 2009
CheckHers Elite 2010
CheckHers Elite 2011
CheckHers Elite 2012
CheckHers Elite 2013
CTLF 09 Red
CTLF 09 White
CTLF 10 Red
CTLF 10 White
FSLAX 2009
FSLAX 2010
FSLAX 2011/2012
FSLAX 2013-2015
Future Elite
Green Turtle Lax 2009
Greene Turtle Bel Air 2012 team
Greene Turtle Bel Air 2009/2010
Greene Turtle Bel Air 2010/2011
Greene Turtle Bel Air 2012/2013
Greene Turtle Bel Air 2013
Greene Turtle Bel Air 2014/15 COMBO TEAM
Greene Turtle Lax 2010
Greene Turtle Lax 2011
Heros 2009
Heros 2010
Heros 2011
Heros 2012
Heros 2013
Heros 2014/2015
Integrity 2012
Integrity 2013/2014
Intrepid 2009
Intrepid 2010
Intrepid 2011
Intrepid 2012
Intrepid Middle School
Island Girls 2011
Island Girls 2013
JCL 2009 Elite
JCL 2010 Elite
JCL 2010 Stars
JCL 2011 Elite
JCL 2014 Elite
JCL Carolina Blue
JCL Navy Blue
Lenape Premier Black
Lenape Premier Teal
LI Liberty 2009 Black
LI Liberty Lax 2009 Red
LI Liberty Lax 2010 Black
LI Liberty Lax 2010 Red
LI Liberty Lax 2011 Black
LI Liberty Lax 2011 Red
Long Island Express 2011 Blue
Long Island Express 2011 White
Long Island Express 2012 Blue
Long Island Express 2012 White
Long Island Express 2013 Blue
Long Island Express 2013 White
Long Island Wave 2010
Long Island Wave 2011
Long Island Wave 2012
Long Island Wave 2013
Looneys 2009-2010
Looneys 2010-2011
Looneys 2012
Looneys 2013-2014
Metro Brown 2014
Metro Gray 2014
Metro Orange
Metro Pink 2013
Metro Purple 2013
Metro Yellow
NBC 2009
NEMS 2009
NEMS 2010
NEMS 2011
NEMS 2012
NEMS 2013
NEMS 2014
Ohio Premier 12-13
Ohio Premier 2010
Ohio Premier 2011
PA Express 2009
PA Express 2010 Blue
PA Express 2010 Orange
PA Express 2011
Penn Premier
Phantastix 2010 Purple
Phantastix 2010 White
Phantastix 2011 Purple
Phantastix 2011 White
Pixie Stix
Ravens 2009
Ravens 2010
Ravens 2011
Ravens 2012
Ravens 2013
ROME 2009
ROME 2010
ROME 2011
ROME 2012
ROME 2013
ROME 2014
SEPA 2009
SEPA 2010 Green
SEPA 2011
SEPA 2012
Shooting Stars 2009
SPLax 2009
SPLax 2010
SPLax 2011
SPLax 2012
SPLax 2013
SPLax 2014
Star Riders Red
Star Riders White
Star Riders-JV
STEPS 2013 Blue
STEPS 2013 White
STEPS 2014/2015
STEPS Elite 2009 Blue
STEPS Elite 2009 White
STEPS Elite 2010 Blue
STEPS Elite 2010 White
STEPS Elite 2011 Blue
STEPS Elite 2011 White
STEPS Elite 2012 Blue
STEPS Elite 2012 White
Team Integrity MS
TLC 2010 Red
TLC 2010 White
TLC 2011
TLC 2012 White
TLC 2013 Red
TLC 2013 White
TLC 2014
TLC 2015
Wave Lacrosse Club
Yellow Jackets 2012 Blue
Yellow Jackets 2013 Blue
Yellow Jackets 2014 Blue
Date of Birth mm/dd/yyyy
Age:
10
11
12
13
14
15
16
17
18
19
20
Parent/Guardian:
Address:
City:
State
:
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
:
US Lacrosse Member #
Contact Phone(###-###-####):
Player Email:
Parent Email:
School Attending:
Grade:
2
3
4
5
6
7
8
9
10
11
12
Graduation Year
2008
2009
2010
2011
2012
2013
2014
2015
2016
Position
Goalie
Defense
Mid/Defense
Midfield
Mid/Attack
Attack
Jersey Number
ROSTER INFORMATION
The following is required for rising seniors and will be given to college coaches for recruiting purposes.
Height :
4'9
4'10
4'11
5'0
5'1
5'2
5'3
5'4
5'5
5'6
5'7
5'8
5'9
5'10
5'11
6'0
6'1
6'2
6'3
6'4
6'5
Weight
SAT
ACT
GPA
Class Rank
Amateur Minor Athletic Waiver and Release of Liability
In consideration of being allowed to particpate in any way in the
Champions of Tomorrow®
athletics/sports program and related sports and activities the undersigned:
Agree that the parent(s) and/or legal guardians will instruct the minor particpant that prior to participating he or she should inspect the failities and equipment to be used, and if the particpant believes anything is unsafe, he or she should immmediately advise his/her coach or supervisor of such conditions and refuse to particpate.
Acknowledges and fully understands that each participant will be engaging in activities that involve risk or serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction or negligence of others, the rules of play, or the condition of the premises or any equipment used. Further, that they may be other risks not known to us or not reasonably forseeable at this time.
Assume that all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
Acknowledge and fully understand that each participant is not covered under this policy for expenses due to the individual's allergic reactions or asthma conditions.
Agree to have information submitted in this form published in Club National Championship programs and/or promotional materials..
Releases, waives, discharges and covenants not to sue the
Champions of Tomorrow®
, its affiliated clubs, their respective administrators, directors, agents, coaches, and other employees of the organization; other participants, sponsoring agencies, sponsors, advertisers; and if applicable, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as "releases", from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.
SIGN
I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY