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Shoot Around September 14 through October 7, 2010
 
Form  
1.  Last Name*
2.  First Name*
3.  School You Attend
4.  Gender*
5.  Street Adddress*
6.  City*
7.  Zip Code*
8.  Emergency Phone Number (xxx-xxx-xxxx only)*
9.  Date of Birth (MM/DD/YY)*
10.  Email Address*
11.  Years of Experience*
12.  Grade (Fall 2010)*
13.  Position you play*
14.  US Lacrosse Membership Number (must have www.uslacrosse.org)*
Thank you for registering for the Memphis Lacrosse League Event. This confirms you have registered for the event. This is only a confirmation of registration you will need to mail a check to: 6645 Poplar Ave #208, Germantown, TN 38138 or drop a check off at our store. Thanks
15.  Release and Waiver of Liability (Read Carefully before submitting)*
 I AGREE     
* required field