CAPITAL LAND LACROSSE AND FIELD HOCKEY

CO-PRESIDENTS: Gary R. Weiss MAILING ADDRESS: 7 Azalea Ct., Clifton Park, NY 12065

Chad C. Finck WEBSITE: www.CapitallandLacrosse.com

PHONE: (518) 527-1340 or 527-6110 E-MAIL:

MEN’S FALL & WINTER LACROSSE PROGRAMS/LEAGUE 2013/14

FOR AGES 16 AND OLDER

The Capitalland Lacrosse Club has three programs planned for the fall and upcoming winter on the turf fields at the Sportsplex in Halfmoon. See each section below for details. The registration form for all three of our lacrosse programs is on page two of this document. The Sportsplex, not us, also is requiring a one time, yearly building access fee of $12. If you have already paid this fee to the Sportsplex within the past year for any sport or function you do not have to pay this for a full year from the date you made your payment.

FALL LACROSSE PROGRAM FOR MEN 16 YEARS OF AGE AND UP -

Open to all men 16 and older. This competitive program will feature games each week that include college aged players and older as well as experienced high school junior and seniors. Player can register by mail to the address above or show up 20 minutes early each night to sign in.

DATES/TIMES: Wednesday Sept. 25, October 2 and October 9 starting at 9:30 pm.

COST: The fee is $16 a night or $40 for all three session.

MEN’S 18 AND OLDER LACROSSE LEAGUE *More league info is on page two of this form.

DATES & TIMES OF THE LEAGUE - the league will play ever Wednesday night starting the week of 10/16 and ending 11/20 with games starting at 9:30.

LEAGUE FORMAT OF PLAY will include weekly divisional play. Records will be kept. Playoffs will be held after the regular season concludes. Each game will be refereed by at least one qualified referee and supervised by a CLL representative.

PLAYERS OR TEAMS CAN ENROLL USING ONE OF THE FOLLOWING THREE MEANS. A group of players can form a full team enter that group as a team. A group of players can get together join as a partial team. An individual can sign up as a free agent they will be placed w/ other free agents on Capitallands team. No current high school players will be allowed to play except goalies.

REGISTRATION can be done by sending the application on the back of this form to the address written above. We will be accepting applications ½ hour prior to each scheduled session at the Sportsplex as long as spots are available. *Full and partial team captains must e-mail me a roster by 10/13. My e-mail address is

FEES The fee for the league is $105 when signing up by 10/15 and $115 after that date. There is no pay per night program in our leagues.

CHRISTMAS BREAK LACROSSE for Men 17 and over.

During the holiday break we will be have a special come and play program that will feature a round robin nightly lacrosse tournament. On the evenings listed below we will break into teams and play multiple games. Come with your friends and play on the same team or as a free agent and we will put you on a team. Players do not to sign up in advance just show up 20 minutes before each playing date to sign in. The cost per night is only $13 a night.

CHRISTMAS BREAK LACROSSE will be held on the following Wednesdays - December 4th from 9:30 to 10:30 pm

- December 11th from 9:30 to 10:30 pm

- December 18th from 9:30 to 10:30 pm

Breakaway Sports and Brine/Warrior are official sponsors of Capitalland Lacrosse.

REGISTRATION FORM to be used if you are registering by mail or for walk in sign ups players at the Sportsplex. To register on line see the registration section of the other side of this form

Name:______E-Mail address ______

Program enrolling in – circle one Fall lacrosse - Men’s winter league - Christmas break lacrosse

Address: ______City: ______State: _____ Zip Code: ______

Phone #: ______DOB______Position______Are you new to Capitalland Y ___ N ___

To register by mail, Capitalland Lacrosse, 7 Azalea Ct. Clifton Park, NY 12065 Registrations will also be accepted ½ hour prior to each scheduled session at the Sportsplex as long as spots are available.

For our winter league - check the appropriate O below.

O Full team member. Team name/captains name is ______.

O Partial team member. Team name/ captains name is ______.

O Free agent.

***Before anyone can take the field at the Sportsplex ofhalf moonthey must complete the following. Go to sportsplexofhalfmoon.com and click the link in the top right corner that reads Member Login and pay their once a year $12 fee. Please Call the Sportsplex with any issues on how to register. (518) 383-0991

GAME SITE: The Sportsplex of Halfmoon is located off exit 8A of the Northway. Head East off of the exit until you reach Route 9. Turn left and go about two miles. The Sportsplex is on the left behind the Soccer Unlimited Store on Corporate Drive. Enter at the sign for Pai’s Tae-kwon-Do.

Bad weather: If weather conditions are threatening, please contact 527-1340 or 527-6110 one hour before play is to begin to see if lacrosse is still going to be held.

*LEAGUE NOTES - The format of play will be in a 2-3-2 set up. Each game will have two 22-minute running halves with a five-minute half time. Jersey’s - each player will receive an official game pinnie. Since players do miss games because of work, sickness, vacations ... each team will have a minimum of fourteen players on their rosters and a maximum of eighteen. Capitalland holds the right to add players to a team that does not sign up with a full team of at least 14 players. All players need to check in fifteen minutes before their first game to pick up their schedules, pinnies, and league rules. Limited body checking will be allowed. A league schedule will be provided online before the start of week two. A team has until the start of the third week of play to add a player to their roster

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MEDICAL TREATMENT AUTHORIZATION

PLAYERS NAME______I do hereby authorize Capitalland Lacrosse Club, Inc. and it’s duly authorized agent(s) permission to request medical treatment, as necessary, to assure the well-being of our child.

Sign here - (Player’s signature)______

MEDICAL INFORMATION SECTION (To be completed by a player)

As stated on our Insurance Waiver forms, there always is a risk that injury (ies) or various physical/emotional conditions may result in a need for medical attention. To help the coaches and staff better monitor and respond to these possibilities, please describe any restriction(s) that may apply, and any medication needs that require our attention. Thank you for your cooperation in providing this information.

RESTRICTIONS:______MEDICAL NEEDS ______

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Coverage for accidental injury is required for all participants. Your family health plan is your level of protection. Our insurance contract allows no one to play in a Capitalland program until proof is provided and both waiver and release forms are completed.

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FAMILY HEALTH INSURANCE COMPANY HEALTH INSURANCE POLICY NUMBER

You are engaging in a physically strenuous sporting activity that can result in physical contact and unintended injury. As the player or the parent or guardian (s) of the applicant in the Capitalland Lacrosse program I agree to, waive, discharge and covenant not to sue the Capitalland Lacrosse Club, Inc., their affiliated clubs, their respective administrators, participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and leasers of premises used to conduct the events, all of which are hereinafter referred to as “releases:, from any and all LIABILITY to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise.

I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.

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(Signature of player or / guardian) (Printed Name of player / guardian)