Mike Robel’s

Lacrosse Academy Camp Registration Form

 

Name:_________________________________

 

Grade:_________

 

Position:__________________

 

Address:___________________________

              ___________________________

              ___________________________

 

Phone #___________________

 

Email:_________________________________________

 

Payment:  2 Options:

 

                         Pay Online

      

                                        Or

                    Mail checks with this form to:  

 

Lax Academy

26 Roselle Ave

Cranford NJ 07016

 

Any questions please call 908-489-1499 or

Email me at laxacademy@yahoo.com