1CAPITALLAND LACROSSE AND FIELD HOCKEY CO-PRESIDENTS - GARY R. WEISS & CHAD C. FINCK MAILING ADDRESS - 7 AZALEA COURT CLIFTON PARK, NY 12065

WEB SITE – CAPITALLANDLACROSSE.COM E-mail - [email protected] PHONE NUMBERS: 527-1340 / 527-6110

INDOOR WINTER LACROSSE 2014 - 2015 DECEMBER, JANUARY & FEBRUARY

CHRISTMAS BREAK LACROSSE for Males age 16 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 $14 a night. CHRISTMAS BREAK LACROSSE will be held on the following Wednesdays - December 3th starting at 9:30 to … - December 10th starting at 9:30 to … - December 17th starting at 9:30 to … - January 7th starting at 9:30 to … - January 14th starting at 9:30 to …

MEN’S / BOYS age 16 and over WINTER LEAGUE*More league info is on page two.

DATES & TIMES OF THE LEAGUE - the league will play ever Wednesday night starting the week of 1/21/15 and ending 2/25 excluding 2/18 with games starting at 9:30 and all games will end around 10:30. 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. ELIGIBLE PLAYERS - This league is open to all male players 16 and over. 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 with other free agents on Capitallands team. 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 1/19/15. My e-mail address is [email protected] FEES – The fee for the league is $85 when signing up by 1/19/15 and $95 after that date. We do not allow pay per night players in our leagues. SPORTSPLEX FEE: The Sportsplex also is requiring a one time, yearly access fee of $12 that is payable to them. This is not a fee that we charge so do not pay us. Any & all players who play at the Sportsplex are charged this fee. If you have already paid this fee to the Sportsplex within the past year for any sport you do not have to pay it again for a full year. If you have not, then please go on line before the first night & do this by going to sportsplexofhalfmoon.com & click the link in the top right corner that reads Member Login. Sportsplex is 383-0991 if help is needed. EQUIPMENT – will be available to rent for the season on the first night for a small fee. A security deposit is required that will be given back when the equipment is returned. All players need to wear gear that is mandated by NYS and NCAA rules.

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

E-MAIL US AT [email protected] TO BE PUT ON OUR E-MAIL LIST

REGISTRATION FORM FOR MEN’S / BOYS LEAGUE Name:______E-Mail address ______Program enrolling in – circle one - Christmas break lacrosse - Men’s Jan./Feb. league 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 league - check the appropriate O below. *If in high school place name of school here ______. O Full team member. Team name/captains name is ______. O Partial team member. Team name/ captains name is ______. *If you selected the partial team member, list the other team members & their positions on a piece of paper & send it with this form so we can make sure we get you on the same team. O Free agent. ***Before anyone can take the field at the Sportsplex of Halfmoon they 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 ______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 ______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. ______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. ______(Signature of player or / guardian) (Printed Name of player / guardian)