Medusa Field Hockey

Skills & Strategies Indoor Clinic

Players First Name:

Players Last Name:

Players Grade:

Phone Number (for emergency use):

Email Address (clinic updates):

Is there anything you think we need to know about your child (allergy, diagnosis, etc)?

I understand that my daughter is participating in a contact sport and has been asked to wear protective equipment such as shin guards & mouthpiece. I release Medusa Lacrosse LLC and their staff from any type of accident/injury/death that I understand could happen as a result of participating in the field hockey clinic. I also understand that Medusa Lacrosse will be taking pictures/videos of my child and possibly using them for advertisement purposes only.

Signature of Parent/Guardian:

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

$375

Medusa Athletics Lacrosse & Field Hockey

Medusa Field Hockey

Medusa Athletics
Lacrosse & Field Hockey