FSU LACROSSE WINTER PROSPECT CLINIC- 1/28/18

Completion of this online form will hold your spot for ten (10) business days. Please mail payment and the Liability Waiver & Medical Release Statement to Coach Rippey within ten (10) business days. You will receive an email confirming receipt of these items.

ZIP Code *

Email address *

Cell Phone Number *

Address 2

City *

Address 1 *

Last name *

State *

First name *

Year of Graduation *

High School *

Club Team

Primary Position *

G Attack Midfield Defender

Secondary Position

G Attack Midfield Defender

T-shirt Size *

S M L

* required field