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Brian Shanahan Lacrosse School 2004

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Registration Procedure

Complete the entire application form including

Health Card No. and Parent/Guardian signatures.

Make cheque for $199, second child $150, third child $100

payable to: 1205215 Ontario Inc.

Brian Shanahan Lacrosse School

31 Willowbrook Road

Toronto, ON

M8Z 4A8

Note: Because of demand, returning players will be given

priority until April 17th. After that, first-come, first-served.

Space is limited, so register early!

Lunch time will be supervised. Note that meals are not provided.

Please be conscious of peanut allergies, DO NOT send any

lunches with peanuts or peanut ingedients.

Application Form

Brian Shanahan Lacrosse School

Name:____________________________________

Birthdate:__________________________________

Address:___________________________________

_________________________________________

City:____________________ Postal Code________

e-Mail:____________________________________

Home Phone No._____________________________

Business Phone No.___________________________

Cell Phone No._______________________________

Emergency Contact No._________________________

Health Card No.______________________________

Level of Lacrosse (circle one category)

House League Rep Level A B C D

Height________________ Weight ______________

Medical Information / Allergies

_________________________________________

_________________________________________

The applicant agrees that the Brian Shanahan Lacrosse School

and/or its proprietors will not be responsible for any accident

and/or loss, however caused and agrees to release the proprietors

from all claims or damages which may arise as a result of or by

reason of such accident or loss.

_________________________________________

Signature of Parent or Guardian

_________________________________________

Date

I hereby give my permission to Brian Shanahan Lacrosse School to

use and reproduce photographs taken of my child in conjunction

with lacrosse school activities. I agree that all such photographs

shall remain the property of Brian Shanahan Lacrosse School.

_________________________________________

Signature of Parent or Guardian

_________________________________________

Date

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Questions or problems regarding this web site should be directed to [webmaster].

Copyright © 2003 [1205215 Ontario Limited]. All rights reserved.
Last modified: 03/10/04

Photography Courtesy of Graig Abel Photography [eMail]

Official Photographers of the Toronto Maple Leafs & Toronto Rock.