Camp Registration Form

Emergency Phone other than parent *

Complete the form and you will need to mail a check to Coach Cottrell to complete the registration:

Please put the name of the player in the note section of the check.

Homer Lacrosse Camp

C/O Tom Cottrell

186 N. West Street

Homer, N.Y. 13077

Check Payable to: Homer Lacrosse Booster Club

COST:

Pre-register before camp $125.00

Cell Phone *

Players Age: *

Home Phone *

Parents Name: *

Comments/Questions:

Camp Reversible Size (adult) *

Medium X-Large

Parents Email: *

Players Name: *

Position (select one) *

Midfielder Defense

Grade Level (Fall 2019) *

3rd Grade 5th Grade 7th Grade 9th Grade

Homer Lacrosse Camp Registration Page