Victory Girls Lacrosse Summer Camps

Intensive 4-Day Camps, led by Camp Instructor Steve Shipe and the Victory Girls Lacrosse Staff. Two sessions are available for girlsí ages 7-17. Campers will be grouped by age and ability to create the most beneficial learning environment.

June 20-23
West Chester

Stetson Middle School
1060 Wilmington Pike 
West Chester, PA 19382

June 27-30
South Jersey

Marlton Park
123 Marlton Rd
Pilesgrove, NJ 08098


Multiple Venues
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Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. Please note, you may see all or any portion of the following on your bank or credit card statement: "MSI*PATTISONSPORTSGROUP 8882448044 ONLINE REG FEE". Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

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Registration inquiries:
Kara Gredell
Administrator, Victory Girls Lacrosse
Pattison Sports Group
(484) 352-3546
kara@pattisonsportsgroup.com
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PLAYER INFORMATON
West Chester - June 20-23
South Jersey - June 27-30
Goalie
Middie
Defense
Attack

EMERGENCY CONTACT INFORMATION
In Consideration of my participation in YOUR NAME HERE . sponsored events and activities, I
agree to the following:

1. Waiver and Release: I am fully aware of and appreciate the risks, including the risk of
catastrophic injury, paralysis, and even death, as well as other damages and losses, associated
with participation in a lacrosse event and related sports conditioning activities. I further agree
on behalf of myself, my heirs and personal representatives, that YOUR NAMES HERE along with coaches, officials, referees, volunteers, employees, agents, sponsors, officers,
and directors of these organizations, 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.

2. Medical Attention: I hereby give my consent to First Class Lacrosse Plus, LLC. to provide,
through a medical staff of its choice, customary medical/athletic training attention,
transportation and emergency medical services as warranted in the course of my participation
in YOUR NAME HERE sponsored or sanctioned events.

3. Readiness to Compete: I will only participate in those competitions or activities in which I
believe I am physically and psychologically prepared to participate.

As legal guardian of this participant, I herby verify by my signature below that I have read and
fully understand each of the conditions under Participant Waiver and Release section for permitting my
child to participate in any YOUR NAME HEREsponsored events and activities and I accept each
of the conditions, especially the waiver and release set forth in paragraph one.

Insurance Information
All participants are required to be covered with insurance for accidental injury. In most instances, family
health insurance is adequate. Please indicate your family health insurance plan above.

Medical Treatment Authorization
I/We being the legal guardians of the applicant authorize First Class Lacrosse Plus LLC and its agentís
permission to request medical treatment as necessary to insure the well being of our dependent.
Check this box to indicate that you have read and agree to all of the above terms & conditions