Smithsburg’s Second Annual
Come ReLAX this Summer!!
Who: future 9th – college players and alumni
What: 1.5hrs of pick up play – 15 min of warm up time allotted
When: June 11- July 16 Tuesdays 6:30-8pm
Where: Smithsburg High School girls lacrosse practice (field behind school near stadium)
Bring: stick, mouth guard, goggles, cleats, water
Provided: pinnie, medical supplies, refs, good times
Cost: $25 for 6 game package or $5 per game – pay and play
Pay by check made out to Smithsburg High School – girls’ lacrosse in the note or cash
Game Day Cancellations? Find us on Facebook: Smithsburg High School Girls Lacrosse
Return this Participant Information Sheet and registration fee to
Smithsburg High School
Attention: Jessica Klinger
66 North Main Street
Smithsburg, MD 21783
(Checks made out to Smithsburg High School)
Questions? Contact:
Coach Jessica Klinger
klingjes@wcps.k12.md.us
Phone: 301-766-8337
Fax: 301-824-2617
Participant Information Sheet
Participant Information:
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* First Name: ________________________
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* Last Name: ________________________
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* Address: ________________________
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* City: ________________________
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* State: ________________________
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* Zip: ________________________
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* Phone: ________________________
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* Email: ________________________
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* Age: ________________________
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* Current School: ________________________
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* Emergency Contact Name (First & Last):
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________________________
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* Relationship to Participant:
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________________________
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* Emergency Contact Phone Number:
* Known health concerns:
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Waiver of Liability:
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In signing this registration form, I, ________________________, (parent/guardian) release Smithsburg High School, Washington County Public School System, and all other involved parties from any claims or responsibility for injuries suffered at the clinic. I knowingly assume all risks for the participant associated with the participation, even arising from negligence of the participants or others, and assume full responsibility for participation. I certify that the participant stated above is in good physical condition and can participate in the ReLaxing Summer League. Further, I authorize the clinic staff to act on behalf of the participant in securing medical treatment, as necessary, to insure the participant's well-being.
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* Signature of Parent/Guardian: ___________________
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Date: ___________________
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