FLL Registration

$175  |  $200

DUES INCLUDE: Uniform (Jersey & Shorts) League Fees, Fields Usages, Referees, & Website Maintenance. Dues must be paid by Venmo to @Justin-Merchant before the first game of the season.

    Personal Information

    First Name *

    Middle

    Last *

    Preferred Name

    Phone Number *

    Email Address *

    Address *

    City *

    State *

    Zip *

    Player Information

    Jersey # *

    Position *

    Height *

    Weight *

    Hometown, State *

    College *

    Grad Year *

    US Lacrosse Membership

    BECOME A MEMBER

    Membership Number

    Expiration Date

    Emergency Contact Information

    Emergency Contact

    Emergency Phone

    Emergency Email

    Insurance Carrier

    Policy Number

    I have read and agree to the Concussion Waiver Acknowledg​ement

    Venmo

    @Justin-Merchant | $200Early Reg. $175
    Cash, Check, & PayPal are also acceptable.

    FLL Registration

    $125  |  $150

    DUES INCLUDE: League Fees, Fields Usages, Referees, & Website Maintenance. We will be wearing the same jerseys as last year. We have extras if someone needs to replace a pair at an additional cost. Dues must be paid by Venmo to @Justin-Merchant before the first game of the season.

      Personal Information

      First Name *

      Middle

      Last *

      Preferred Name

      Phone Number *

      Email Address *

      Address *

      City *

      State *

      Zip *

      Player Information

      Jersey # *

      Position *

      Height *

      Weight *

      Hometown, State *

      College *

      Grad Year *

      US Lacrosse Membership

      BECOME A MEMBER

      Membership Number

      Expiration Date

      Emergency Contact Information

      Emergency Contact

      Emergency Phone

      Emergency Email

      Insurance Carrier

      Policy Number

      I have read and agree to the Concussion Waiver Acknowledg​ement

      Venmo

      @Justin-Merchant | $150Early Reg. $125
      Cash, Check, & PayPal are also acceptable.

      Registration

      $100

      DUES INCLUDE: Fields Usages, & Website Maintenance. Dues must be paid by Venmo to @Justin-Merchant before the first game of the season.

        Personal Information

        First Name *

        Middle

        Last *

        Preferred Name

        Phone Number *

        Email Address *

        Address *

        City *

        State *

        Zip *

        Player Information

        Jersey # *

        Position *

        Height *

        Weight *

        Hometown, State *

        College *

        Grad Year *

        US Lacrosse Membership

        BECOME A MEMBER

        Membership Number

        Expiration Date

        Emergency Contact Information

        Emergency Contact

        Emergency Phone

        Emergency Email

        Insurance Carrier

        Policy Number

        I have read and agree to the Concussion Waiver Acknowledg​ement

        Venmo

        @Justin-Merchant | $100.00
        Cash, Check, & PayPal are also acceptable.

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