FOUR STAR LACROSSE CHALLENGE CAMP
ONLINE REGISTRATION

Thank you for registering online for the Four Star Lacrosse Camps.  There are three steps left in the registration process:

Step 2: Fill out and Submit the form below.

Step 3: Pay the registration fee either on our secure online server or by mailing us a check.

Step 4: Fill out and send in your Medical Form.

Camper Information
First Name		Last Name
E-Mail Address		Note: All future messages from us will be sent to this e-mail address.
Confirm E-Mail Address		Please re-type your e-mail address to confirm that it is entered correctly.
US Lacrosse Member No.
Address
City
State	none Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming	Zip Code
Phone
Age
Height
Weight

Parents' Contact Info
Mother's Name		Mother's Phone
Father's Name		Father's Phone

School Info
High School	Please Select A. Spalding Albertus Magnus Babylon Bayport Bayshore Bellport Bethpage Bishop Timon Brentwood Bryant Buffalo HS Calhoun Carey Chaminade Clarke Cold Spring Harbor Commack Comsewogue Connetquot Copaigue Corning East, NY Deer Park Division Ave East Islip East Meadow Easthampton Eastport Elmont Fallston HS Farmingdale Floral Park Foxboro, MA Freeport Friends Garden City Glen Cove GN North GN South Greenport Hanover Park Harborfields Hauppauge Hempstead Herricks Hewlett HHH East HHH West Hicksville Holy Trinity Huntington Island Trees Islip Jericho JFK Bellmore Kellenberg Kings Park Lawrence Lindenhurst Locust Valley Long Beach Longwood MacArhthur Malverne Manhasset Massapequa Mattituck Mepham Mercy Middle Country Mineola Mt Sinai NH Park North Babylon North Shore Northport Oceanside Old Mill OTHER Pat-Medford Plainedge Plainview Port Washington Riverhead Rocky Point Roslyn Sachem East Sachem North Sayville Seaford Sewanhaka Shoreham-WR Smithtown Southhampton Southside St Anthonys St John Baptist St Marys Stonybrook School Syosset Toms River, NJ Uniondale VS Central Walt Whitman Wantagh Ward Melville West Babylon West Hempstead West Islip Westhampton Wheatley William Floyd Xaverian HS	If "Other", type School name here:
Grade in Sept '09	6th 7th 8th 9th 10th 11th 12th	Jacket Size	Small Medium Large X-Large XX-Large
Position	ATTACK Att/Mid MIDFIELD Long-stick Midfield DEFENSE Goalie

Team Camps
Team Camp Type	VARSITY JV JUNIOR

Additional Clinics
CLINIC DAY	FACE OFF	STRENGTH AND SPEED TRAINING	GOALIE
Monday	FACE OFF NOT SELECTED	STRENGTH AND SPEED NOT SELECTED	GOALIE NOT SELECTED
Tuesday	FACE OFF NOT SELECTED	STRENGTH AND SPEED NOT SELECTED	GOALIE NOT SELECTED
Wednesday	FACE OFF NOT SELECTED	STRENGTH AND SPEED NOT SELECTED	GOALIE NOT SELECTED
Thursday	FACE OFF NOT SELECTED	STRENGTH AND SPEED NOT SELECTED	GOALIE NOT SELECTED

Website User Info
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