Manhattanville Valiants Women’s Lacrosse Presents:
SPRING LACROSSE CLINIC
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WHEN:
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Sunday March 4, 2012 (Rain Date Sunday March 18th) 12:00pm-3:00pm
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WHERE:
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Manhattanville College- GoValiants.com Field (Field Turf and grass field)
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WHO:
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Open to all girls 1st -8th grades (girls will be split in groups by age and/or talent)
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COST:
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$65 per player (No Refunds)
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WHAT PARTICIPANTS WILL RECEIVE:
- Three hours of lacrosse fun and learning. Including instruction from the Manhattanville Women’s Lacrosse Staff and Players
- Individual Skill development
- Competitions and scrimmages
WHAT TO BRING:
- Lacrosse stick, mouth guard, goggles and water bottle
- Cleats, Turfs or Sneakers
Please fill out and return the form below, by 2/29/12, with a check made payable to Manhattanville Women’s Lacrosse to:
Anna Riordan, Women’s Lacrosse, Manhattanville College, 2900 Purchase Street, Purchase, NY 10577
If you have any questions please contact us:
Head Coach- Anna Riordan Anna.Riordan@govaliants.com Office: (914) 323-5204
Assistant Coach- Liz Falco Falco@govaliants.com Office: (914) 323-3174
Assistant /Goalie Coach- Marissa Bonitatibus
Name____________________________________Team/Town Name___________________________
Address____________________________________________City________________________
State_________________Zip___________________ Grade (Circle) 1 2 3 4 5 6 7 8
Phone______________________________Email______________________________________
I, the undersigned parent/legal guardian of ____________________, authorize said child’s participation in the Manhattanville College Girls Lacrosse Clinic. I hereby agree that I will not hold Anna Riordan, her staff, the Athletics Department, Manhattanville College or its employees responsible for any loss, damages, or personal injuries that may be received as a result of participation. I certify that my child is in excellent physical health and is capable of participating in all activities associated with this lacrosse clinic. I also give my permission for any emergency medical care of treatment by a physician, surgeon, hospital or medical care facility that may be required, and accept the responsibility for that cost. I have read and fully understand this release statement.
_________________________________________ __________________
Signature of parent or guardian Date
Please list any health issues that the staff or those providing care should be aware of:
______________________________________________________________________________________________
Primary Care Physician_____________________________________Phone_________________________
Insurance Company______________________Group #_________________Policy #_________________
Emergency Contact________________________Relation______________Phone____________________
