Registration Team Name* Team Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Team CoachCoach's Name* First Last Coach's Cell Phone Number*Coach's Email* Team ContactContact's Name* First Last Contact's Cell Phone Number*Contact's Email* We are requesting the following number of games (up to 3 Varsity, 2 JV on Saturday)Saturday (1 hr Jamboree Style) $200/gameVarsity* Price: $200.00 Quantity: JV* Price: $200.00 Quantity: Sunday (Regulation Game) $300/gameVarsity* Price: $300.00 Quantity: JV* Price: $300.00 Quantity: Do you want Sunday games to count on LAX Power?*YesNo(Please choose "No" if no Sunday games)Scheduling Requests(We will do the best we can to accommodate your request.)InsuranceOur players are covered by*School InsuranceUS LacrosseNote: Teams covered by US Lacrosse must submit their complete rosters with Names and US Lacrosse Numbers by February 8, 2019. Teams covered by school insurance must submit proof of insurance along with their roster.File UploadUpload your roster and insurance information below Drop files here or Select files Accepted file types: xlsx, xlsm, xltx, xltm, docx, pdf, Max. file size: 256 MB, Max. files: 5. Please include names and US Lacrosse numbersT-shirt Pre-orderPre-order your tshirts online. Shirts are $20 each.Small* Price: $20.00 Quantity: Medium* Price: $20.00 Quantity: Large* Price: $20.00 Quantity: Xtra Large* Price: $20.00 Quantity: Payment InfoTotal Cost $0.00
