Preliminary Registration Form

Name_______________________ Phone_____________Age____

Address________________________City____________State_____

Zip__________ Parent Email________________________(required)

Parent/Guardian_____________________(alt) Phone____________

Cell Phone_____________School_________________Grade_______

Position________  Years Playing Lacrosse_____

Specify Camp:         

    East Camp   $135 (  )  with lunch  $160 (   )

    Guilford Lax Camp: Day  $285 (  )  Overnight  $425 (  )  

    Roommate Preference (Guilford Camp)_______________________

    Phillip's Camp   $105.00 (  )

Medical forms and Confirmation letters will be sent via email.  Lacrosse is a contact sport and participants assume risk of liability.  Participants will only take part in activities in which he is physically capable.  Catalax Camps assume no liablity as the result of injury by participants.  I hereby acknowledge that my son is covered by a health insurance policy, listed below, and I authorize camp personel to, in case of injury, to contact healthcare provider of choice to provide prompt care.

Signature of Parent______________________________________________Date______________________

Health Insurance Company_________________________________________Policy #__________________

Please print, complete, and return this form , along with check, to Cat-A-Lax Camps, 617 Caswell Road, Chapel Hill, NC  27514.

Pay Online, over secure server, http://www.nclaxacademy.com/events.asp

Please print and complete the above application, then send it via mail after registering online.

THANK YOU!  You will receive confirmation and further instructions by Mid June.