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 | $200 Early 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 | $150 Early 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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