UNIVERSITY OF MICHIGAN
WOMEN’S LACROSSE
PRE-SEASON CLINIC!

Who:	High School and Middle School Girls of all skill levels

When: 	Saturday, February 7, 2004, 1-4pm

Where: 	Michigan’s Oosterban Field House
	   	South State Street, Ann Arbor

Why:  	Sharpen and perfect your old skills and learn new ones…before the season starts! 

Clinicians:	Mary Ann Meltzer, Head Women’s Lacrosse Coach, Two time All American at the University of Maryland, US Team Member 1989-1993, Atlantic Coast Conference 50th Anniversary Team, 2002 Inductee to The Ohio Lacrosse Hall of Fame.
	John Sung, Assistant Women’s Lacrosse Coach at The University of Michigan.  Help led Birmingham Unified to 4 state Championships, Goalie Coach Specialist.  		
	University of Michigan Lacrosse Players, 2002 and 2003 WDIA Final Four Team

Clinic Format: 	 Michigan Coaches and players will work with small groups of similar ability levels on stick skills, agility and strategy.

Cost:	Only $40, if you pre-register (postmarked by January 31st) and $50 if you register that day.  Checks are payable to U of M Women’s Lacrosse.

Send:	Please send check, registration and release forms to:

University of Michigan Women’s Lacrosse
21772 Glenwild Drive
Northville, MI 48167
T-shirts will be sold for $10

 Any questions can be directed via e-mail to:  Alyson Gilbride at agilbride@umich.edu or Alana Rubin at rubinar@umich.edu
University of Michigan Women’s Lacrosse Clinic
Registration/Emergency Form

Name: ___________________________
Address __________________________
Home Phone: __________________________
Birth date: _________________________
Year in School: _________________________
Years of Lacrosse Played: __________________________

Parent/Guardian Name: _________________________
Work Phone: _________________________
Home Phone:  _________________________
Parent/Guardian Name: _________________________
Work Phone: _________________________
Home Phone: _________________________

Doctor’s Name: _________________________
Doctor’s Phone Number: _________________________
Dentist’s Name: _________________________
Dentist’s Phone Number: _________________________
Preferred Hospital: ____________________________
Emergency Clinic: _________________________

Please Indicate Appropriate Conditions (Explain if necessary):

Religious objections to physician contact ____________________________________________________
Contact lens/glasses _____________________________________________________________________
Bone/Joint condition _____________________________________________________________________
Diabetes ______________________________________________________________________________
Heart Condition ________________________________________________________________________
Seizure Disorder _______________________________________________________________________
Hypertension or High Blood Pressure _______________________________________________________
Asthma _______________________________________________________________________________
Special Blood Condition _________________________________________________________________
Life Threatening Allergies ________________________________________________________________
Medications needed/used _________________________________________________________________
Other Conditions/problems ________________________________________________________________
None Known ___________________________________________________________________________

Participation Release Form

I hereby release The University of Michigan, The Women’s Lacrosse Club, and their agents, representatives, and assigns from any responsibility or liability for any damages arising from personal injuries or property damage or loss arising from participation by my (daughter), (ward), in such activities.  This is a release not only of my own rights as the (father), (mother), (guardian), but also the rights of my minor (son), (daughter), and (ward).

Signature of Parent or Guardian		Date			Phone Number
__________________________	___________		________________

Send Registration Form and $40 Check payable to University of Michigan Women’s Lacrosse to:
University of Michigan Women’s Lacrosse, 21772 Glenwild Drive., Northville, MI 48167