YMCA Learn to Play
Lacrosse Clinic

Fall 2011

Who:  Boys and Girls in grades 3-6
When: Every Sunday Sept 18-Oct. 30
Time: 1:00pm-2:30pm
Where: J.B. Chambers YMCA in Elm Grove
Fee: $25 YMCA Members $40 Non Members

~ All participants will receive a T-Shirt and Water Bottle ~

Equipment needed: Lacrosse Goggles, Mouthpiece, Lacrosse Stick

Deadline to Register: Sunday Sept 13, 2011

Camp Coaching Staff: Chuck Scatterday - Ohio County Phantoms, Meghan Dent-Carmen - Wheeling Jesuit University,
Tyler Henk - Wheeling Jesuit University, Joseph Subasic - Wheeling Park High School,
Gary DeCock - Pittsburgh Select Lacrosse, Devin Calmbacher - West Liberty University,
Collin Burke - West Virginia University

For More info call (304)242-8086 or email: Chuck@wheelinglacrosse.com


Name: _______________________________ Address:_______________________________

City: ___________________ State: _________ Zip:________

Phone: ________________ School: _____________________________ Grade:____

Shirt size: YM YL AS AM AL AXL (Circle One)

 In submitting this entry, I, for myself, my heirs, and administrators waive and release all rights and claims for damages I may have against the Wheeling YMCA and all other sponsors for any injury suffered by my child in this activity. I attest and verify that I have full knowledge of the risks involved in this activity.

  
Parent Signature :___________________________________________Date:__________
 

2011 YMCA Fall Lacrosse Clinic

Paid:__________ Date: ___________ Clerk: ________ Rec #___________________

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