Registration

RAGE LACROSSE CAMPS ONLINE REGISTRATION

* Indicates required field

Age Range *

Ages 11 and Under Ages 12 - 18

Which camp would you like to register for? *

Participant's Name *

First

Last

Participant's Age *

Participant's Gender *

Male Female

Playing Division *

Home Club (Indoor) *

Home Club (Outdoor) *

Are You a Goalie? *

Yes

Jersey Size *

Address *

City *

Postal Code *

Phone Number *

Emergency Number *

BC Medical Number *

Special Medical Conditions *

How did you hear about the Rage to the Cage Elite Lacrosse Camps? *

Email *

By checking this box/waiver I consent to my child's participation in the camp. I assume all the risks that incidental to such participation. I therefore agree to waive, indemnify and hold harmless the camp and the arena hosting the camp, as well as their employees, contractors and agents. I certify that my child is in good physical and mental health. In case of surgical emergency, and I cannot be reached, I hereby give permission to the physician selected by the Camp to hospitalize and secure proper treatment for my child. *

I acknowledge reading this application and declaration, and under the condition herein agree to abide all the terms.

The registered participant and parents/guardians hereby agree that the Rage to the Cage Lacrosse Camp and its administrators will not be held responsible for any accidents or loss however caused and agrees to release all instructors, staff, and sponsors from all claims or damages, which may arise as a result of/or by reason of such accidents or loss.

The price of the camp is:

$275 FOR PLAYERS AT THE BURNABY 8 RINKS
(LUNCH IS INCLUDED)

$275 FOR PLAYERS AT THE CHRYSLER ARENA
(LUNCH NOT INCLUDED)

$195 FOR GOALIES

Early Bird Special:

$250 FOR PLAYERS AT THE BURNABY 8- RINKS AND CHRYSLER ARENA
$150 FOR GOALIES

SPRING BREAK EARLY BIRD DUE BY FEBRUARY 1 2020
(For Burnaby 8-Rinks and Chrysler Arena)

SUMMER BREAK EARLY BIRD DUE BY JUNE 1 2020
(For Chrysler Arena)

SUMMER BREAK EARLY BIRD DUE BY JULY 1 2020
(For Burnaby 8-Rinks)

We accept payment by cheque or by cash in person only. There is a $15 service charge for bounced cheques. Make cheques payable to "Rage to the Cage Lacrosse Camp" and mail to:

1220 Dunlop Ave.
Burnaby, BC
Canada V5B 3X1

Submit