Registration – Pershing Lacrosse Club

Player Full Name

Player Date of Birth

Player Street Address

City

State

Zip/Postal Code

Player Phone Number

Player Email

Grade Level

Read the policy here: Rules and Regulations

I have read the Pershing Lacrosse Club Rules and Regulations policy. I understand and agree to abide by the rules outlined. I further understand that each player is required to participate in one Pershing Lacrosse service project.

I Agree

I hereby authorize the Pershing Lacrosse Club to a) record my likeness and voice on video, audio, photographs, digital, electronic, or any other medium b) Use my name in connection with these recordings c) Use, reproduce, exhibit or distribute in any medium, including but not limited to, print publications, video recordings, and the internet. I hereby release Pershing Lacrosse Club for any violation of any personal or proprietary right I may have in connection with such use. I understand that all such recordings, in whatever medium, shall remain the property of Pershing Lacrosse Club.

I Agree

I hereby certify that my son has my approval to play at home or away on the Pershing Lacrosse team. I understand and agree that the HISD Board of Education and the employees and agents of HISD assume no responsibility or liability for any accident or injury as a result of any aspect of participation in lacrosse. In the event of an injury, I hereby grant permission to school officials and employees to render, secure, and authorize necessary treatment. I understand that medical expenses for injuries will be paid only according to the HISD Department of Athletics rules, and such payments do not waive HISD's general immunity or create any liability for injuries or damages.

I Agree

Read the concussion policy here: Concussion Acknowledgement

I have read and understand the Concussion Acknowledgement Policy.

I Agree

Parent 1 - Full Name

Parent 1 - Street Address

Parent 1 - City

Parent 1 - State

Parent 1 - Zip/Postal Code

Parent 1 - Phone Number

Parent 1 - Email

Parent 2 - Full Name

Parent 2 - Street Address

Parent 2 - City

Parent 2 - State

Parent 2 - Zip/Postal Code

Parent 2 - Phone Number

Parent 2 - Email

The THSLL requires that all players have a valid U.S. Lacrosse membership. Membership is $35 per year and you can sign up at the U.S. lacrosse website.

U.S. Lacrosse Number

U.S. Lacrosse Number Expiration Date

Uniform Size (Shirt)

Uniform Size (Shorts)

Uniform Size (Pinnie)

How many years of lacrosse have you played?

Which is your preferred position?

Do you have any scheduling conflicts? If you have known schedule conflicts (school events, work, family, or other obligations), please provide details.

Please upload a scanned copy of your completed physical. You can find the Physical form here.

Physical Form

We need your help! Don't worry if you've never seen a lacrosse game or helped before-we will show you what to do. If you are interested in any of the following positions, check the box. If there's something not listed, please add it at the bottom.

Volunteering Options

Fundraising - Corporate Donors (help to find corporate sponsorships) Videographer (Capture video of games for coaches' use) Photographer (Contribute photos for team use on social media, etc) Home Field Volunteer (Help with stats, scoreboard, clock, etc - TRAINING PROVIDED) Team Mom Helper/Assistant (Help the Team Mom as needed) Other

If you selected other, please add details here

I have read the Payment and Refund Policy and I understand the Pershing Lacrosse Club fee, payment, and refund policy.

Payment and Refund Policy

I agree

How will you pay your player dues?
Players: $400

Paypal
Venmo
A check made out to "Pershing Boy's Lacrosse Club"