2014 Girls Lacrosse Grades 1-4 Registration Form

All fields with a * must be completed in order for the form to be submitted.

Please complete and submit the following Medical Information, Registration and Release Form for the LO Parks & Recreation Girls Lacrosse Start-Up Program for grades 1-2 and the Skills & Scrimmages Program for grades 3-4.

Complete a separate form for each child.

Form Deadline: March 20, 2014

Registration and payment can be made at www.loparks.org


Complete shirt size for the Skills & Scrimmages grades 3-4 program only.  If your size needed is not available, please contact Jodi at 503-534-5742 with size.
Please provide the following contact information:
List any medical condition(s) that the Program Coordinator should be aware of:
Are there any special accommodations needed for your child to participate in this program?
EMERGENCY CONTACT (other than parent/guardian)