2023 Motor City Machine Registration Form

Product Name

Select Season*

Summer programs*

Tournament Team Play (Complete Selections Below)
Remaining 5Wed/Thurs Summer Training

Fall Programs (select all that apply):*

Beginner Intro to Lacrosse Level 1
Beginner Level 2 Training (4 sessions; Boys & Girls)
Session #1 Train & Play (5 sessions for HS Girls)
Session #2 Train & Play (5 sessions for HS Girls)
Tournament Team Play (Includes Session #1 Training!) Complete Sections Below

Winter Programs*

HS Girls Train & Play (Jan-March)

Spring Programs*

Grades 3-6: Girls Team Training
Grades 7-8: Girls Team Training

Total

$0.00

Participant Information

Player`s Name*

First Last

Participant Gender:*

Current or Previous Lacrosse Team or Club Affiliation*

School*

Grade in 2023-24 School Year*

Team Level Request*

Date of Birth*

MM

DD

YYYY

Height*

Weight*

Want to attend a Summer Tournament? Select what tournament(s) you can attend:*

Select All
July 15-16 Great Lakes Invitational ($200)
July 22-23 Summer Finale ($200)
Aug. 12-13 Midwest Finalax (Marshall, MI)

Signing up for a Fall Tournament? Pick Only One Option below - Session #1 Training included!*

Oct 1: Northwood Univ. 5v5 ($150)
Oct 7: Shootout on the Shore ($175)
Both Northwood and Shootout on the Shore Tournaments ($225)

Player is interested in playing*

Goalie
Defense
Midfield
Attack
Not Sure Yet

Experience Level*

"Play With" Request:

In the interest of keeping players together with their teammates and improving the experience for our players, we will do our best to accommodate registrants' requests to play with their friends/teammates where roster space permits.

Optional Machine Lacrosse Club Scholarship Donation

Are you able to help fund a player in financial need? Each session we offer families in need a reduction in their fees so their player can participate in our programs. Your help is greatly appreciated!

Do you need a Motor City Lacrosse practice/scrimmage pinnie?*

No, I do not need one.
Yes, I need a L/XL
Yes, I need a S/M

A one-time purchase of a Motor City Lacrosse team training pinnie/jersey is required for tournament team play and training programs. It is not required for one-day clinics or special events.

UNIFORM ORDER: Do you need a team uniform (jersey, skirt, socks, shooter shirt)?*

Yes, I need a new uniform set.
No, I already have a uniform set.

If ordering a team uniform, please indicate your jersey size*

If ordering a team uniform, please indicate your short/skirt size*

If ordering a team uniform, please indicate your shoe size for sock ordering.*

If requesting a new team uniform, what number(s) would you like to have if it's not already taken?

Please enter a number from 1 to 99.

We will try to accommodate your request!

Parent/Guardian(s) Name(s)*

Relationship to Participant*

Mother
Father
Guardian
Grandparent
Aunt/Uncle

Address*

Street Address Address Line 2 City State ZIP

Home Phone Number:*

Cell Phone:*

Email*

Optional (Additional) Email Address to send team communications

EMERGENCY CONTACT INFORMATION:

Emergency Contact Name*

First Last

Relationship to player:*

Emergency Contact Phone:*

Please note any medical concerns for the participant (see also waiver requirements)

Insurance Provider:*

Policy No.

Accept Agreement*

I have read and I understand this Agreement. I warrant that I have the right and the authority to execute this Agreement on behalf of myself and the Participant (if under the age of 18). I assume full responsibility for the terms and conditions of this Enrollment Agreement & Release, and will indemnify and hold harmless Motor City Lacrosse, LLC for any claims brought by or on behalf of Participants to this Agreement.

By indicating your acceptance, you understand, agree, warrant and covenant as follows:
MOTOR CITY LACROSSE ENROLLMENT AGREEMENT & RELEASE
FOR 2023 PROGRAM PARTICIPATION
The Participant desires to participate in the Motor City Machine Lacrosse program of Motor City Lacrosse, LLC (referred to herein as Motor City Lacrosse). This form is an important legal document. It is critical that you read and understand it completely. After you have done so, please print your name legibly and sign below. In this document, the term "Participant" includes both the on-the-field Participant and the parent or legal guardian, if Participant is under 18 years of age. Participation in the sport of lacrosse may result in injury or death to Participants. Participant desires to participate in the sport of lacrosse despite these risks. Participation in the Motor City Lacrosse program is expressly conditioned upon the following agreement by the Participant:
1. Participant assumes all risks of injury or death sustained while participating in the sport of lacrosse or while on or about the premises, and waives all liability against Motor City Lacrosse, their officers, employees and all affiliated entities.
2. Participant releases, discharges, indemnifies and holds harmless Motor City Lacrosse, their officers, employees, agents, officials, and all related entities, from any and all claims, demands or causes of action that are in any way connected with participation in the sport of lacrosse or use of the premises, facilities or equipment, and including any negligence on the part of East Side Lacrosse, their officers, employees, agents, officials and all affiliated entities.
3. Motor City Lacrosse is not responsible for Participant's fitness, abilities or equipment.
4. Participant represents and acknowledges that Participant has adequate insurance and agrees to assume full responsibility for any and all costs or expenses occasioned by an injury or medical need arising out of participation in the sport of lacrosse or use of the premises, facilities or equipment.
5. Participant acknowledges that during the course of their activities, Motor City Lacrosse may take Participant's photograph or film a video that includes the participant. Each Participant hereby grants Motor City Lacrosse permission to use any such photograph or video for use in materials promoting Motor City Lacrosse. Such use may include publication in program, general advertising, posters, flyers, television, internet, and any other vehicles that may be distributed or shown to or otherwise seen by large numbers of individuals and potential patrons of Motor City Lacrosse. Participant waives all rights to any financial remuneration of any kind.
6. I understand that Motor City Lacrosse reserves the right to remove any participant whose behavior is deemed disruptive to the best interest of the program or those interacting with the program with no refund of fees paid.

Pledge

I pledge to Compete with Class and Honor the Game.

PARENT / PLAYER PLEDGE FOR THE 2023-24 LACROSSE SEASON
The Motor City Machine Lacrosse Club welcomes you and your player(s) to the team. Motor City Machine Lacrosse is about players having fun while learning, training and competing in the game. As parents, part of your role is to make sure that your child is enjoying her lacrosse experience.

This season, as a parent or player, I pledge to Compete with Class and Honor the Game.
• I will honor the history of women’s lacrosse and commit to maintaining the core values of the game’s culture.
• I will recognize the value of safe and fair play by teaching, enforcing and playing by the letter and spirit of the girls’ game.
• I will practice and encourage good sportsmanship by demonstrating positive support for all players, coaches and officials at every game, practice or other girls’ lacrosse event.
• I will place my player's safety, health and well-being above all other interests to compete and win.
• I will support coaches and officials working with players in order to encourage a safe, positive and enjoyable experience for all.
• I will do my very best to make the sport fun for every participant.
• I will ask all family members and fans to be tolerant and inclusive by treating other players, coaches, fans and officials with high regard and respect.