2nd Annual LACROSSE for CEREBRAL PALSY
A Fundraising, Awareness and
High School Lacrosse Recruiting Event
"Life without limits for children and adults with disabilities"



















Interested in
sponsoring the
event?
Click here



Want to
Volunteer to help
at the event?  
Click here
First Name *
Last Name *
Graduation Year  for HS or current grade in Middle School*
Position *
School*
Age as of Jan. 1, 2010 *
Date of Birth (MM/DD/YYYY) *
Your email address *
Home phone number *
Cell phone number *
(yours or parents)
Address *
City *
State *
Zip Code *
Emergency Contact *
Emergency phone number *
Name of Insured *
Insurance Provider *
Insurance Policy Number *
UCP Division *
UCP Team Coach *
Additional Information you would like to give:
2010 UCP TOURNAMENT REGISTRATION FORM

PLEASE FILL OUT THE REGISTRATION FORM BELOW IF YOU ARE SIGNING UP AS AN
INDIVIDUAL.  MAKE SURE YOU CHOOSE YOUTH OR HIGH SCHOOL DIVISION.  ALSO,
PRINT OUT LIABILITY FORM BELOW.

AFTER YOU CLICK SUBMIT, PLEASE PRINT CONFIRMATION PAGE AND SEND IT ALONG
WITH A CHECK FOR $50.00 MADE PAYABLE TO: United Cerebral Palsy of Delaware with
"Lacrosse Tournament" in memo line.

MAIL TO:            LACROSSE FOR CEREBRAL PALSY
                        c/o Z CAMPS, LLC
                        PO BOX 253
                        KIRKWOOD, DE 19708

REGISTRATION DEADLINE FOR INDIVIDUAL PARTICIPANTS IS OCTOBER 1, 2010.


Please print out and bring to check in:
Individual Player Liability Form