Wrestling Lacrosse
Information
HYAA Home Page 		 

HYAA BOYS Spring Lacrosse Registration
Select League Boys K-2 Clinic         Boys Grades 3-8 Team
       
Youth's Name
Last
First
     
Address
Holmdel, NJ  07733		 NOTE: THIS REGISTRATION IS AVAILABLE FOR HOLMDEL, NJ RESIDENTS ONLY
Birth Date
Grade (2016-2017)

 

  1. Fitness
    I am personally satisfied as to my youth's fitness to participate in this activity. HYAA strongly recommends that you seek professional medical advice if there is any doubt about your youth's fitness to participate in this activity.

  2. I understand that while every effort is made by the volunteers to protect the safety of the participants, HYAA assumes no responsibility for any injures or accidents that may occur. Each individual participating is doing so at his own risk and by signing this document agrees to release HYAA from any and all liability with respect to any injury or accident, which may occur at the facilities.

  3. HYAA is a volunteer organization. You must volunteer for one of the assignments below in order for your registration to be complete. Note: Coaches MUST be Rutgers certified and Kid Safe screened. NO EXCEPTIONS.

    1.   2.   3.

  4. Emergency Contact
    In Emergency situations you should contact

Father Name   

   

Mother Name   

Primary Phone #   

Secondary Phone #   

Email   
   
Fees
   
Registration Fee
$50 late fee applies after June 19, 2008
 
Clinic - Grades K - 2 $110
Team - Grades 3 - 8 $170
  $50 late fee will be added after Feb 17    
Sibling Discount First Child
($0)
  Second Child
($10)
  
Each Additional Child
($15)
  
Association Fee Once per family, per year (HYAA's year is Sep 1 - Aug 31)
$25
  
Total Amount Due (+3% convenience charge)..............$ 

Submitting this registration form will reserve your child's spot for this season. However, the registration will not be processed until payment is received. PAYMENT FOR ONLINE REGISTRATIONS CAN ONLY BE MADE BY CREDIT CARD. After you click SUBMIT below you will be prompted for your credit card information via our secure payment form.

HYAA is not an affiliate of the Holmdel Board of Education

CODE OF CONDUCT

I understand that ALL parents must sign the HYAA Code of Conduct

Credit card required to submit online registrations

NOTE: All participants will be assigned to leagues on a first come first served basis.