YOUTH CAMP AND TOURNAMENT REGISTRATION FORM:

____ Session I: July 6-9 (Youth camp and Rising JV tournament)

____ Session II: July 13-16 (Rising Varsity tournament)

Name: _____________________________________________ Age: ___________

Home Address: ______________________________________________________

City: ________________________________ State: ____________ Zip: _________

Home #: ___________________________ Cell or Work #: __________________________

E-mail: _____________________________________________________________

Roommate Preference: ________________________________________________

Lacrosse Information
School/Club: ________________________________________________________

Grade Completed: ______________________ Years Experience: ______________

Position: ___________________________

To order an STX strung head, Heatgear shirt by Under Armour, or an STX equipment bag, please check the appropriate box(es) and add to camp balance.

____ STX Hype Head (strung), add $80

____ Under Armour Tech-T, add $20 (circle one) S, M, L, XL, XXL

____ Warrior “Black Hole” Bag 42”, add $60

Fees: (check one)

____ Resident Camper- $475 (includes breakfast, lunch, and dinner)

____ Day Camper- $350 (includes lunch & dinner)

____ Commuter Camper- $275

A DEPOSIT of $200 per session is required if paying by check. All DEPOSITS are NON-REFUNDABLE after June 1st, 2008. Enrollment for tournaments are limited to the 1st- (16) teams. Sign up by April 1st and save $15.00 per youth camper or tournament player.

Please make check(s) payable to:

The Elite 150, Inc. and send to:

Tom Gravante
Mount St. Mary’s University
16300 Old Emmitsburg Road, Emmitsburg, MD 21727
or Fax: (301) 447.6723

Office: 301.447.5356
Cell: 301.471.8206
Email:gravante@msmary.edu

Visit us @ www.theelite150.com

Registration Discounts:

Please Check Discounts

____ Early Registration Discount - $15.00, (Must be received by April 1st, 2008.)

____ Brother Discount - $15.00/son. (Brothers do not have to
attend same session, but registrations must be sent together with $200 deposit/camper.)

All BALANCES are due by June 15th, 2008. All DEPOSITS are NON--REFUNDABLE after June 1st, 2008.

Please complete balance information by circling all that apply:

Resident Camper: $475

Day Camper: $350

Commuter camper: $275

Stick - Add $80

Shirt - Add $20   Indicate size: S, M, L, XL, XXL (youth sizes)

Bag - Add $60

Total Fee____________

Add $20 Key Deposit:   ____________________(Resident Campers Only)
Enter Discount(s)           (         )
Registration Deposit     (         )

Balance remaining: ____________

I hereby authorize The Elite 150 Lacrosse Camp to act on my behalf according to its best judgment in any medical emergency. I verify to the best of my knowledge that the above named applicant is physically able to participate in all camp and tournament activities. I, the undersigned, waive and forever discharge Mount Saint Mary's University, Tom Gravante, and the Elite 150 Lacrosse Camp and Summer-16 tournaments, its staff, officers, agents, representatives, employees and successors from all rights and claims for damages to person or property while at the camp site.

Parent/Guardian Signature: _____________________________________________________
Date: ________________________________

Medical insurance information, treatment authorization, and waiver and release:

Applicant Name: ______________________________________________________________

Medical Insurance Company: ____________________________________________________

Group/Policy # _______________________________________________________________