Little Laxers North Shore | Medusa Lacrosse

Medusa Little Laxer Roslyn Spring 2025 Clinic

Playes First Name

Players Last Name

Players Grade

Nursery

PreK

K

1st

Parent Email Address

Phone Number (for emergency)

Is there anything you think we should know about your child? (diagnosis, allergies)

I understand that Medusa Lacrosse LLC will be taking photos/videos of my child and using them for advertisement purposes. I also understand that I am registering my child for a contact sport and my child is at risk for injujry and/or death and do not hold Medusa Lacrosse LLC and staff responsible.

Signature of Parent/Guardian

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Medusa Little Laxers Roslyn Spring 2025

Little Laxers Roslyn Registration200

Medusa Athletics Lacrosse & Field Hockey

Medusa Little Laxer Roslyn Spring 2025 Clinic

Medusa Athletics
Lacrosse & Field Hockey