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PLAYER INFORMATION
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First name:
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Last name:
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US Lacrosse #:
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Exp Date:
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Position:
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ie: Goalie, defense, attack, midfield
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Years of Experience:
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Graduation Year:
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Date of Birth:
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Email address:
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Note: Ryquin communicate primarily through
email. The emails may be new to your email
account, please check spam box.
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Phone #:
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Address:
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Street
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City
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State
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Zip
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HEATH INSURANCE INFORMATION
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Health Insurance Carrier:
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Policy #:
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Policy Holders Name:
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PARENT/GUARDIAN & EMERGENCY CONTACT INFO
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Parent/Guardian Name(s):
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Phone number(s):
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Parent/Guardian Email:
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Emergency Contact:
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Emergency Phone #:
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Comments:
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ADDITIONAL INFORMATION
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CANCELLATION POLICY: No refunds will be offered for the Davis Play Day.
Please make sure that you are able to make the commitment before registering.
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Please mark box with "X" stating that you have read, understand and agree:
- to the cancellation policy.
- that Davis Play Day team practices are Friday, October 21st and 28th at Lincoln Village
Park, Ranhco Cordova from 4p-6p - recommended, but not required.
- that players are responsible for their own transportation to and from practices/play day
- that the WAIVER FORM will be scanned and emailed to admin@ryquin.com by October 7th
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I have read, understand and agree.
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Please note:
- Please review all information. Once you hit submit, you will not be able to make changes.
- Payment must be made at the time of registration form submission. FEE: $50
- Once you hit submit:
- Your registration form will be sent to Ryquin.
- You will then be directed to the Pay Pal payment page.
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