Scarborough School Team Registration

Registration

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Scarborough School Team Registration

This form is for grades 7 through 12 only!

(Please follow the Youth Lacrosse link for younger players.)

We will use the information you provide here to create several printable forms in Adobe Acrobat format. We will email those forms to you. You will need to print and sign those forms, and then bring or mail them back to ???.

Please provide the requested information and then send electronically by clicking on the "Register Now" button at the bottom of this form.


Fields marked with a red asterisk (*) are required.

Program Selection: (For which program is the player registering?)
	Program Name*:

Player Information:
Name	(as it appears on the birth certificate)
	First*:
	Middle:
	Last*:
Address
	Street*:
	Street (if needed):
	City/Town*:
	State*:
	Zip*:
	Lived here since (year)*:
Contact
	Telephone*: (Include area code)
	Email*: (The address to which we should send your forms)
Personal Data
	Date of Birth*: (mm/dd/yyyy)
	Grade*:
	Height*: (total inches only)
	Weight*:
	Years of lacrosse experience:

Father Information:
Name
	First*:
	Last*:
Address
	Street*:
	Street (if needed):
	City/Town*:
	State*:
	Zip*:
Contact
	Day Telephone*: (Include area code)
	Evening Telephone*: (Include area code)
	Mobile Telephone: (Include area code)
	Email 1:
	Email 2:

Mother Information:
Name
	First*:
	Last*:
Address
	Street*:
	Street (if needed):
	City/Town*:
	State*:
	Zip*:
Contact
	Day Telephone*: (Include area code)
	Evening Telephone*: (Include area code)
	Mobile Telephone: (Include area code)
	Email 1:
	Email 2:

Emergency Contact Information: Person other than parents listed above. Used only in emergency, only if neither parent can be reached.
Name
	First*:
	Last*:
Address
	Street*:
	Street (if needed):
	City/Town*:
	State*:
	Zip*:
Contact
	Day Telephone*: (Include area code)
	Evening Telephone*: (Include area code)
	Mobile Telephone: (Include area code)
	Email 1:
	Email 2:
	Relationship to Player*:

Medical Insurance Information:
	Carrier Name*:
	Policy Number*:
	Policy Holder*:

Physician Information:
Name
	First*:
	Last*:
Contact
	Telephone*: (Include area code)

Medical Information:

	1. Has your child had any injuries that required medical attention in the last year?*:	Yes No

	2. Has your child had any illness lasting more than one week in the last year?*:	Yes No

	3. Is your child currently under a physician's care?*:	Yes No

	4. Is your child currently taking any medications?*:	Yes No

	5. Do you know any reason why your child should not participate in interscholastic athletics?*:	Yes No

	Date of last Tetanus booster (mm/dd/yyyy)*:

	Pre-existing Conditions*: Allergies Chronic Illnesses Medications carried by your child Explanations for Questions 1-5 above (If there are none, please enter 'None')
Miscellaneous Notes:
	Enter notes here:

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