Enrollment Form for Camp Hillard Boys Lacrosse Clinic 2020

Camp Hillard will be offering a lacrosse clinic for boys entering 3rd thru 8th grades.
Monday, Tuesday, and Thursday, September 14, 15, and 17, with a Friday, September 18 rain date if one of the other days are cancelled. Each clinic will be held from 4:30 pm to 6:00 pm each day.
Clinic fee: $150. Upon submitting this form, you will be taken to the payment instructions.

Program: Each clinic will consist of 10 minutes of footwork, 30 minutes of stick work, 10-15 minutes of station work, 10-15 minutes of unsettled situations, 10-15 minutes of shooting for offensive and defensive skills, and 20 minutes of game play (2 v 2, 3 v 3, 4 v 4). Participants should bring their own equipment consisting of shoulder pads, arms pads, gloves, mouth piece, stick, and water bottle, but no cleats, please. The clinics will be run by Coach Tim Weir, Camp Hillard's head sports counselor and current varsity head lacrosse coach of Putnam Valley High School, and formerly the head varsity head lacrosse coach of Lakeland/Panas high school that include 4 Section 1 championships. Tim will be assisted by other coaches and we will split out the boys into a younger and an older age subgroup as needed to properly address the different skill levels.

See the informational email you received for equipment needed and procedures and protocols to follow.

Please Enroll:

CAMPER 1

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

CAMPER 2

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

CAMPER 3

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

Last Name

First Name

Gender

Date of Birth (M/D/Y)

School

Present Grade

Home Address:
City: State: Zip: Home Phone:

If mail is to be addressed other than Mr. & Mrs., please indicate accordingly :

Father's Name
Father's Business Firm & Address
Father's Business Phone
Father's Cell Phone
Father's Email

Mother's Name
Mother's Business Firm & Address
Mother's Business Phone
Mother's Cell Phone
Mother's Email

This Enrollment Form must be electronically signed by a parent or guardian. Signature confirms that the parent or guardian agrees to the above financial terms and dates and authorizes camper(s) to attend Camp and participate in the clinic. Also, in the event that your child needs immediate medical care and neither a parent or guardian nor your child's physician is available, the camp may seek emergency treatment. Signature also authorizes the camp to publish photos of above campers in marketing materials and on the camp's website.

Furthermore, the signature confirms that the parent or guardian acknowledges that there is no way to fully eliminate the risks associated with the cornonavirus. The program and procedures have been communicated to the parent or guardian who understands and accepts any of these risks associated with attending Camp.

ELECTRONIC SIGNATURE:
Parent's or Guardian's Full Name
Date