Registration - Coquitlam Jr Adanacs

Registration

Registration Form for Players

Name

Address

Street Address

City

Country

Phone number

(XXX) XXX-XXXX

Twitter

Please put none if you do not have a twitter account

Year Born

e.g. 2001

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 ritual

Lacrosse Goal

Favorite food

Discount

Subtotal

Tax

Total CAD