Registration - Coquitlam Jr Adanacs

Registration

Registration Form for Players

Due to the Covid Pandemic, we will need you to fill out the following forms before you can step on the floor for the Junior Adanacs.

Any questions or troubles accessing this forms please reach out to Kerry McGaffney. kmcgaffn@gmail.com

Players Name

Parents Names

Parents Email

Address

Street Address

City

Country

Home number

(XXX) XXX-XXXX

Cell number

(XXX) XXX-XXXX

Players Email

Twitter

Please put none if you do not have a twitter account

Instagram

Birth Date

Height

Feet/Inches

Weight

Pounds

BC Medical #

Other Information

Last Years Club

Returning Jr. Adanac Player Graduated from Coquitlam Midget Wanting to Tryout from outside Coquitlam

Pinnie # (If you have one)

University attending/commitment

Please enter University you will be attending

Expected Date of return from University/College

Best lacrosse memory

Lacrosse Goal

Favorite food

Discount

Subtotal

Tax

Total CAD