Middlebury Youth Lacrosse Club (VT)

Middlebury Youth Lacrosse Club

MYLC - Registration for 2012 Lacrosse Season

New Registration Process - please read!

Registration will be handled directly by MYLC, not through the Middlebury Recreation Department. This year there will be no kick-off meeting as there was in the past. Each team will have a mandatory meeting for parents and players at the first practice. If needed, helmets will be distributed and fitted at that time.

Please register as follows:

Establish or renew required membership to U.S. Lacrosse ONLINE by March 15 (must be valid through July 1, 2012). Please make sure you associate your player with Middlebury Youth Lacrosse Club, Group ID: 467250. Note: Location is listed as Bridport.
Complete the MYLC Registration form below.
Pay Fees by March 15 to receive an early registration discount (see below).
You may pay via PayPal or send check made out to MYLC to:

M.Y.L.C.
c/o Grover Usilton
P.O. Box 967
Middlebury, VT 05753

FEES:

Teams Grades Cost by March 15 after March 15

     Boys

          Cubs 3rd & 4th $45. $65.

          Cats 5th & 6th $65 $85

          ClubMidd 7th & 8th TBD TBD

     Girls

          Lady Cubs 3rd & 4th $25. $45.

          Lady Cats 5th & 6th $45. $65.

          ClubMidd 7th & 8th TBD TBD

Scholarships are available through the Nathaniel Ketcham Memorial Fund.

MYLC - Registration Form

U.S. Lacrosse #:
You must register or renew your US Lacrosse membership online at US Lacrosse apply/renew online. Please make sure you associate your player with Middlebury Youth Lacrosse Club, Group ID: 467250. Note: Location is listed as Bridport.

Select Team

Boys Cubs (3rd/4th) Cats (5th/6th) ClubMidd (7th/8th)
Girls Lady Cubs (3rd/4th) Lady Cats (5th/6th) Lady ClubMidd (7th/8th)

Player Information

Last Name: First Name: Nickname:

Birthday: Grade: Home Phone:

May we print the player's name and phone number on the team roster? Yes No

Custodial Parent(s) (Primary, if applicable): Last Name: First Name(s):

Home Phone: Work Phone: Cell Phone:

Town of residence:

Primary Email Address:

Health Concerns:

Parents, please note: While MYLC wants to be responsive to individual situations, parents are responsible for informing coaches and being present to oversee special health care concerns. MYLC cannot be responsible for individual assessments and treatment.

Emergency Contact:

Name: Relationship:

Phone: