2022 Fall Registration

Click here for Fall Program Details

2022 Fall Registration

* Indicates required field

Participant's Name *

First

Last

Parent/Guardian Email *

2nd E-mail *

2022-23 Grade *

Fall Program *

Player Experience *

2022-23 School *

Projected High School *

D.O.B. (mm/dd/yyyy) *

Click Here to find your US Lacrosse Membership Number, Click Here for steps to become a member under Electras.

US Lacrosse Membership # *

T-shirt size *

Phone Number *

Emergency Phone Number *

Address *

City *

State *

Zip Code *

I'm interested in volunteering as coach *

Yes No

Electras Lacrosse has my permission to use photos of my daughter caputured during program and team events for the team's website and facebook page only. Names would not be included. *

Yes No

Please list medical conditions or allergies relevent to participating in athletics *

Additional Comments *

ACTIVITY RELEASE OF LIABILITY

In exchange for participation in the activity of Girls Lacrosse organized by Electras Lacrosse, of 4969 Verbena Street, Denver, Colorado, 80238 and/or use of the property, facilities and services of Electras Lacrosse. I agree for myself and (if applicable ) for the members of my family, to the following:

I agree to observe and obey all posted rules and warnings, and further agree to follow any oral instructions or directions given by Electras Lacrosse, or the employees, representatives or agents of Electras Lacrosse.
I recognize that there are certain inherent risks associated with the above described activity and I assume full responsibility for personal injury to myself and (if applicable) my family members, and further release and discharge Electras Lacrosse for injury, loss or damage arising out of my or my family's use of or presence upon the facilities of Electras Lacrosse, whether caused by the fault of myself, my family, Electras Lacrosse or other third parties.
I am a current US Lacrosse Member under Electras Lacrosse.
I agree to indemnify and defend Electras Lacrosse against all claims, causes of action, damages, judgments, costs or expenses, including attorney fees and other litigation costs, which may in any way arise from my or my family's use of or presence upon the facilities of Electras Lacrosse.
I agree to pay for all damages to the facilities of Electras Lacrosse caused by my or my family's negligent, reckless, or willful actions.
I consent to the participation of my daughter, named above in the "Participants Name" box, in the Electras Lacrosse program, and agree on behalf of the above minor to all of the terms and conditions of this Agreement. By signing this Release of Liability, I represent that I have legal authority over and custody of the person named in the "Participants Name" box.
Any legal or equitable claim that may arise from participation in the above shall be resolved under Colorado law.
I understand that during the participation of lacrosse, with Electras Lacrosse, due to the nature of lacrosse being a contact sport, Electras Lacrosse may not be able to enforce social distancing guidelines of 6ft distance and other recommendations to prevent the spread of COVID-19.

I have read and fully understand the Electras Lacrosse,'s Activity Release of Liability and voluntarily surrender certain legal rights. *

Yes

Submit