2010 Aztec Lacrosse Camp Registration

Choose one camp option?

Day Camp, $445
Overnight Camp, $545

Camper Information

Parent or Guardian Name

Phone, Address, Parent's Email

Camper's Email Address

Please provide an Alternate Emergency Contact:

Insurance Information

Health Insurance Carrier

Enter your Policy Number

Subscriber's Name

Enter your Family Doctor's Name:

Enter your Dr.'s Number:  

MEDICAL ATTENTION: I/We hereby give our consent to the Aztec Lacrosse Camp Personnel to provide, through a medical staff of its choice, customary medical/athletic training attention, transportation and emergency medical services as warranted through the course of my participation in sponsored lacrosse activities.

Medical Attention Consent

WAIVER & RELEASE OF LIABILITY: I/We are fully aware of and appreciate the risks associated with participation in a lacrosse event, including the risk of catastrophic injury, paralysis and even death, as well as other types of damages and loss. I/We further agree on behalf of myself, my heirs, and personal representatives, that Aztec Lacrosse Camp, its directors, coaches, volunteers, employees, agents, and San Diego State University, its officers, staff, and agents shall not be liable for any injury, loss of life or other loss or damage occurring as a result of my participation in the event. Entering our names below is our acknowledgement that we have read and understood every provision of this Waiver and Release of Liability, and that we agree to abide by it.

Waiver & Release of Liability Consent

Guardian Read & Acceptance of Refund Policy

Enter Name of Parent or Guardian who acknowledges understanding of Refund Policy, Insurance Waiver, & Release of Liability: